Complete surgical resection is a well-known therapeutic gold standard for spinal ependymoma, but it is associated with high postoperative morbidity. Intraoperative neuromonitoring (INM) is important for detecting and reducing the rate of surgical complications during this operative procedure. We report a case of postoperative paraplegia due to tumor bleeding during the operation. INM of the patient revealed abrupt loss of waveforms during the operation. This finding suggested that INM is helpful for detecting intraoperative hematomyelia and minimizing postoperative neurologic sequelae.

We performed intraoperative neurophysiological monitoring (INM) during anteromesial temporal resection (AMTR) in a patient with lesional temporal lobe epilepsy. INM revealed a sudden decrease in N20 waves in somatosensory evoked potentials (SSEPs) and poor P100 waves in visual evoked potentials (VEPs). These changes developed after applying electrocoagulation in the right mesial temporal areas. Postoperative brain magnetic resonance imaging demonstrated right thalamic and medial occipital infarctions. SSEPs and VEPs monitoring can be useful for detecting posterior cerebral artery infarction in AMTR.

Citations

• Intraoperative and extraoperative neurophysiological monitoring in epilepsy surgery
  Dae Lim Koo, Dae-Won Seo
  Journal of Intraoperative Neurophysiology.2021; 3(1): 16.     CrossRef