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conferenceseries
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Volume 4
Clinical Neuropsychology: Open Access
Neuropsychiatry 2018
August 27-28, 2018
August 27-28, 2018 Tokyo, Japan
8
th
Global Experts Meeting on
Advances in Neurology and Neuropsychiatry
Neurophysiological monitoring during epilepsy in surgeries
Sergio E Kosac
University of Buenos Aires, Argentina
E
pilepsy surgery originates in the early 20
th
century since the discovery of functional areas, by Broca, Hitzog, and many
others, on one hand. On the other hand, Jackson’s findings, describing the irritative cortical foci and proposing their
excision, until the experiences of WPenfield, who generated a most complete functional cortical map, until that time, specifying
motor and sensitive/sensorial areas, allowed surgical techniques to advance significantly. Nowadays, surgeries for reduction
or elimination of cortical irritative foci are carried out in cases of: Cortical dysplasia, cortical tumors, vascular malformations,
etc. Although more and more accurate and satisfactory surgical techniques were developed, in same cases it is imperative to
preserve functional areas, whenever they are near or over the surgical area. To prevent or minimize damages to such functional
areas, it is necessary to perform intraoperative neurophysiologic techniques. In cases of epilepsy surgeries, there are two
ways: One is the electroencephalogram over the cortex, named electrocorticogram. The other one is the Neurophysiologic
Intraoperative Monitoring (IOM). It is possible through a technique that applies somatosensory evoke potentials, recorded
with a strip of electrodes. Through this technique, we can map out cortex areas, allowing the surgeon to know, before opening
the dura, where those functional areas are. Another technique is, once motor and sensory areas are located to find some
functions over and into the motor area more accurately. This is made with a stimulator given to the surgeon, connected to the
neurophysiologist’ equipment, through which, we can map out more accurate areas i.e., hand area, leg area, etc., applying the
stimulator over some points, and the neurophysiologist delivering stimuli to activate cortical motor neurons, and recording in
the corresponding muscles.
Coolser_4@yahoo.comClinNeuropsychol 2018, Volume 3
DOI: 10.4172/2472-095X-C1-003