What is the role of somatosensory evoked potentials (SEPs) in the workup of intracranial neoplasm?

Updated: Oct 25, 2019
  • Author: Andrew B Evans, MD; Chief Editor: Selim R Benbadis, MD  more...
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Rowed et al used SEP to identify the somatosensory cortex in an effort to help remove intracranial neoplasms and spare eloquent cortex. [70] SEPs were recorded in response to contralateral median nerve stimulation from the cortical surface. Polarity reversal of SLSEP waves was used to identify the position of the central sulcus in 46 consecutive craniotomies for removal of metastases, gliomas, or meningiomas located in, near, or overlying sensorimotor cortex.

SEPs were recorded successfully in 43 of 46 cases (94%), with demonstration of polarity reversal in 42 of 43 cases (98%). SEP localization led to modification of 14 of 42 procedures (33%), most frequently because of either displacement or involvement of sensorimotor cortex by tumor. Six patients (14%) developed new neurologic deficits, but none of these were attributable to incorrect identification of sensorimotor cortex. Routine use of this technique should be considered in all procedures for lesions located near the central sulcus. [70]

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