Section I: Overview and general clinical considerations:
Overview and history. Physiology. Anatomy. EEG and anesthetic effects. Anesthetic effects on EPS.
Section II: CNP techniques used in monitoring neural function during surgery:
Electroencephalography used in monitoring neural function during surgery. Electrocorticography . Direct cortical stimulation to localize sensory, motor, and language function. Deep brain stimulation, electrodeplacement, and pallidotomy monitoring and testing, microneuronography. Visual evoked potentials during surgery. Somatosensory evoked potential monitoring with scalp and cervical recording. Somatosensory evoked potential monitoring with dermatomal stimulation. Monitoring spinal epidural potentials to peripheral nerve stimulation. Somatosensory evoked potentials for intraoperative mapping of the sensorimotor cortex. Motor EP physiology, risks and specific anesthetic effects. Corticospinal tract monitoring with D and I waves from the spinal cord and muscle MEPs from limb muscles. Recording MEPs to transcranial electrical stimulation and SEPs to peripheral nerve stimulation simultaneously from the spinal cord. Transcranial electrical MEP with muscle recording. Neurogenic mixed evoked potentials. Magnetic cortical stimulation techniques. Mapping the corticospinal tract. BAEPs in surgery. Mapping the brainstem: floor of the fourth ventricle. Introperative peripheral nerve stimulation and recording. Intraoperative facial nerve monitoring. Oculomotor and lower cranial nerve monitoring. Intraoperative monitoring with free-running EMG. Introperative EMG during spinal pedicle screw instrumentation. Sacral roots and nerves, and monitoring for neuro-urologic procedures. Motor evoked potentials from external anal and urethral sphincter muscles by transcranial cortical stimulation during surgery. Selective dorsal rhizotomy. Nerve root assessment with SEP and MEP. Technological advances in intraoperative neurophysiological monitoring