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.

The newly identified frontal aslant tract (FAT) that connects the posterior Broca’s area to the supplementary motor area is known to be involved in speech and language functions. We successfully intraoperatively monitored FAT using cortico-cortical evoked potentials generated by single-pulse electrical cortical stimulation in a patient with oligodendroglioma.

Citations

• Developmental trajectory of transmission speed in the human brain
  Dorien van Blooijs, Max A. van den Boom, Jaap F. van der Aar, Geertjan M. Huiskamp, Giulio Castegnaro, Matteo Demuru, Willemiek J. E. M. Zweiphenning, Pieter van Eijsden, Kai J. Miller, Frans S. S. Leijten, Dora Hermes
  Nature Neuroscience.2023; 26(4): 537.     CrossRef

The utility and accuracy of intraoperative neurophysiological monitoring (IONM) has evolved greatly following the recent development of new devices for neurophysiological testing and advances in anesthesiology. Until recently, the need for IONM services has been limited to large academic hospitals, but the demand for neurophysiologists with expertise in IONM has grown rapidly across diverse types of hospital. The primary goal of the Korean Society of Intraoperative Neurophysiological Monitoring (KSION) is to promote the development of IONM research groups and to contribute to the improvement of fellowship among members and human health through academic projects. These guidelines are based on extensive literature reviews, recruitment of expert opinions, and consensus among KSION board members. This version of the guidelines was fully approved by the KSION, Korean Association of EMG Electrodiagnostic Medicine, the Korean Society of Clinical Neurophysiology, the Korean Academy of Rehabilitation Medicine, and the Korean Neurological Association.

Citations

• Intraoperative Monitoring of Sensory Evoked Potentials in Neurosurgery: A Personalized Approach
  Evgeny A. Levin
  Journal of Personalized Medicine.2025; 15(1): 26.     CrossRef
• Role of Intraoperative Neurophysiological Monitoring in Pediatric Tethered Cord Syndrome Surgeries and Technical Insights
  Wael Abd Elrahman Ali Elmesallamy, Alshaimaa Abdel Fattah Kamel, Ahmad Fahmy, Mohamed Elbana, Mahmoud M. Taha
  Indian Journal of Neurosurgery.2025;[Epub]     CrossRef
• A multichannel electromyography dataset for continuous intraoperative neurophysiological monitoring of cranial nerve
  Wanting Ma, Lin Chen, Xiaofan Pang, Yuanwen Zou
  Data in Brief.2024; 53: 110250.     CrossRef
• Intraoperative neuromonitoring in intracranial surgery
  G.B. Adkins, A. Mirallave Pescador, A.H. Koht, S.P. Gosavi
  BJA Education.2024; 24(5): 173.     CrossRef
• Neurophysiological monitoring during endovascular treatment of brain arteriovenous malformations: A meta-analysis
  Francesco Diana, Michele Romoli, Federico Sabuzi, Aymeric Rouchaud, Charbel Mounayer, Géraud Forestier, Alejandro Tomasello, Manuel Requena, David Hernández, Marta De Dios Lascuevas, José Luis Cuevas, Simone Peschillo, Jildaz Caroff, Thanh N. Nguyen, Moha
  Interventional Neuroradiology.2023;[Epub]     CrossRef
• Intraoperative neurophysiological monitoring during the surgeries for the ossification of the posterior longitudinal ligament
  Seol-Hee Baek
  Journal of Intraoperative Neurophysiology.2022; 4(2): 55.     CrossRef
• Hemodynamic Consideration in Intraoperative Neurophysiological Monitoring in Neuromuscular Scoliosis Surgery
  Seok Young Chung, Chae Hwan Lim, Yoon Ghil Park, Hak Sun Kim, Dawoon Kim, Jinyoung Park
  Annals of Rehabilitation Medicine.2022; 46(6): 292.     CrossRef
• Undetected abulic state after anterior communicating artery aneurysm surgery under motor evoked potential (MEP) and somatosensory evoked potential (SEP) monitoring
  Hyesun Lee, Jinseok Park
  Journal of Intraoperative Neurophysiology.2022; 4(2): 78.     CrossRef
• Intraoperative neurophysiological monitoring in pituitary adenoma surgery: case report
  Hyun-Wook Nam, Seol-Hee Baek
  Journal of Intraoperative Neurophysiology.2021; 3(2): 108.     CrossRef

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

Since Hans Berger reported the first paper on the human electroencephalogram in 1920s, huge technological advance have made it possible to use a number of electrophysiological approaches to neurological diagnosis in clinical neurology. In majority of the neurology training hospitals they have facilities of electroencephalography(EEG), electromyography(EMG), evoked potentials(EP), polysomnography(PSG), electronystagmography(ENG) and, transcranial doppler(TCD) ete. Clinicials and electrophysiologists should understand the technologic characteristics and general applications of each electrophysiological studies to get useful informations with using them in clinics. It is generally agreed that items of these tests are selected under the clinical examination, the tests are performed by the experts, and the test results are interpretated under the clinical background. Otherwise these tests are sometimes useless and lead clinicians to misunderstand the lesion site, the nature of disease, or the disease course. In this sense the clinical utility of neurophysiological tests could be summerized in the followings. First, the abnormal functioning of the nervous system and its environments can be demonstrated when the history and neurological examinations are equivocal. Second, the presence of clinically unsuspected malfunction in the nervous system can be revealed by those tests. Finally the objective changes can be monitored over time in the patient's status. Also intraoperative monitoring technique becomes one of the important procedures when the major operations in the posterior fossa or in the spinal cord are performed. In 1996, the Korean Society for Clinical Neurophysiology(KSCN) was founded with the hope that it will provide the members with the comfortable place for discussing their clinical and academic experience, exchanging new informations, and learning new techniques of the neurophysiological tests. The KSCN could collaborate with the International Federation of Clinical Neurophysiology(IFCN) to improve the level of the clinical neurophysiologic field in Korea as will as in Asian region.1 In this paper the clinical neurophysiological tests which are commonly used in clinical neurology and which will be delt with and educated by the KSCN i the future will be discussed briefly in order of EEG, EMG, EP, PSG, TCD, ENG, and Intraoperative monitoring.