Kathylee at 00:25, 14 September 2025

2025-09-14T00:25:52Z

← Older revision		Revision as of 17:25, 13 September 2025
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	'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves.		'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves.

			=== Types of IONM ===
			{\| class="wikitable"
			!Type
			!Stimulate
			!Signal
			!Measures
			\|-
			\|Electromyography (EMG)
			\|Nerves
			\|Muscle response (twitches)
			\|Functional integrity of nerve root and peripheral nerves
			\|-
			\|Motor Evoked Potentials (MEP)
			\|Cerebral cortex
			\|Muscle response (twitches)
			\|Descending motor pathways (e.g. corticospinal tract)
			\|-
			\|Somatosensory Evoked Potentials (SSEP)
			\|Peripheral nerve (e.g. median nerve, ulnar nerve, posterior tibial nerve)
			\|Cerebral cortex
			\|Sensory pathways (e.g. dorsal columns)
			\|-
			\|Electroencephalography (EEG)
			\|Cortex
			\|Cortex
			\|Cortical electrical activity to detect cerebral ischemia
			\|-
			\|Visual Evoked Potentials (VEP)
			\|Light under eyelid
			\|Visual cortex
			\|Optic pathway integrity
			\|-
			\|Brainstem Auditory Evoked Response (BAER)
			\|Sound emission in ear
			\|Auditory cortex
			\|Auditory pathway integrity
			\|-
			\|Direct Stimulation of Specific Nerve
			\|Specific nerve (e.g. facial nerve)
			\|Muscle response (e.g. orbicularis oculi, orbicularis oris, frontalis, mentalis)
			\|Specific nerve function
			\|}

			=== Anesthetic Considerations ===

			* Most to least affected by anesthetics
			** VEP (Very)
			** MEP (Mostly)
			** SSEP (Somewhat)
			** BAER (Barely)
			* Effects of anesthetic medications on neuromonitoring
			** Volatile ↓↓
			** Propofol ↓
			** Benzodiazepines ↓
			** Nitrous ↓
			** Opioids minimal effect
			** Etomidate ↑
			** Ketamine ↑
			* Effect of patient factors on neuromonitoring
			** Anemia, ischemia, hypoxia ↓

			=== Types of Neuromonitoring Used in Specific Surgeries ===
			{\| class="wikitable"
			\|+
			!Surgery
			!IONM
			\|-
			\|Intracranial tumor removal, aneurysm clipping
			\|SSEP, EEG
			\|-
			\|Acoustic neuroma
			\|SSEP, EMG, BAER, CNVII direct stimulation
			\|-
			\|Chiari malformation
			\|MEP, BAER, CNVII direct stimulation
			\|-
			\|ACDF
			\|SSEP, +/- MEP, +/- EMG
			\|-
			\|Thoracic spine surgery
			\|SSEP, MEP
			\|-
			\|Lumbar spine surgery
			\|EMG
			\|}

Chris.Rishel: Created page with "'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves."

2022-04-05T06:37:59Z

Created page with "'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves."

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'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves.

Intraoperative neuromonitoring - Revision history

Kathylee at 00:25, 14 September 2025

Chris.Rishel: Created page with "'''Intraoperative neuromonitoring''' ('''IONM''') is a monitoring technique which is used to assess the integrity of the brain, brainstem, spinal cord, cranial, or peripheral nerves."