| "수술 중 경막하전극상의 체성감각유발전위
상역전에 의한 중심구의 국소지도화" |
| 서대원, 홍승봉 남도현*이정일*김종수*홍승철*박이관*정익수† |
| 성균관대학교 의과대학 삼성서울병원 신경과,삼성생명과학연구소,임상의학연구센터,신경외과*,마취과† |
| "Intraoperative Topographic Mappings of the Central Sulcus by
Somatosensory Evoked Potential Phase Reversals on Subdural Electrodes" |
| "Dae Won Seo, M.D., Seung Bong Hong, M.D., Do-Hyun Nam, M.D.*, Jung-IL Lee, M.D.*,
Jong Soo Kim, M.D.*, Seung Chul Hong, M.D.*, Kwan Park, M.D.*, Ik Soo Jung, M.D.†" |
| "Departments of Neurology, Neurosurgery*, Anesthesiology†, Samsung Medical Center,
SBRI, Sungkyunkwan University School of Medicine" |
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| Abstract |
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"Background : Topographic mappings of somatosensory evoked potentials (SEP) on subdural electrodes help identify the motor cortex quickly during chronic subdural recordings or during the operation. We tried to assess the ease and reliability of the routine use of SEP for identification of the sensorimotor cortex depending on pathology and location of the lesion. Methods : We reviewed 75 SEP studies of 63 patients who needed functional mappings of the sensorimotor area. The phase reversal (PR) of SEP around the 20 msec latency in response to contralateral median nerve stimulations by subdural electrodes was used to identify the position of the central sulcus. The patients included 20 with nonlesional
epilepsy, 30 with tumor, 12 with arteriovenous malformation (AVM), and 1 with cavernous angioma. Results : SEP-PRs were successfully recorded in 67 SEP among 75 studies (89.3%). SEP-PRs were recorded in 37 of 43 patients with lesions (86.0%), and in all patients without lesions (100.0%). In regards to pathology, the absence of SEP-PR was noted in 3 out of 12 patients with AVM (25.0%), 3 out of 30 patients with tumor (10.0%), and 0 out of 1 patient with cav-ernous angioma (0.0%). The SEP-PRs were obtained the least frequently for the location of lesions when the lesions involved both the frontal and parietal areas. Conclusions : Intraoperatively, the SEP-PR can be easily obtained and the median nerve SEP is an useful test for confirming the identification of the central sulcus. SEP-PR can be detected more
frequently in patients without lesions rather than in those with lesions, especially patients with AVM or whose lesions are over the frontoparietal areas. Key Words : Evoked potentials, Somatosensory, Brain mapping, Neurosurgery, Epilepsy." |
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