NEUROPHYSIOLOGICAL AND NEUROPSYCHOLOGICAL MONITORING IN NEUROSURGERY - A REVIEW

Neuromonitoring of neural structures has become increasingly common du ring surgery near cortical areas representing sensorimotor and languag e function (epilepsia, tumors), in the brain stem and the spinal cord (tumors), near cranial nerves (cerebellopontine angle tumors, trigemin al neuralgia, hemifacial spasm), and in the cauda equina (tumors, teth ered spinal cord). The technical spectrum to monitor these operations includes electrical cortical stimulation to evoke sensorimotor phenome na and language disturbances, electro-neurography and -myography of th e cauda equina, motor cranial nerves and nuclei, and somatosensory, mo tor and acoustic evoked potentials. The goals of intraoperative neuro- monitoring are: (1) minimizing the risk of suffering neurological and neuropsychological injury as a result of surgery; (2) extending the su rgical spectrum to lesions that have previously been considered inoper able or hazardous to operate upon; (3) intraoperative electrophysiolog ical documentation that the goal of surgery has been achieved; (4) int raoperative basic research.