Study of Motor Evoked Potential on Intraoperative Neurophysiological Monitoring Cases of Neurosurgeries.

Background: Motor evoked potential (MEP) monitoring is crucial in intraoperative neurophysiological monitoring (IONM) during neurosurgeries, but its effectiveness is influenced by factors such as anesthesia type, patient condition, and surgical technique. Interpreting MEP changes requires expertise due to technical issues and neural injury. Clinical studies show MEPs reduce permanent motor deficits, improving surgical outcomes and patient safety. This study aims to evaluate the efficacy and outcomes of MEP monitoring in IONM during neurosurgeries.

Methods: A cross-sectional study was conducted at King George's Medical University, Lucknow, involving 132 patients undergoing elective surgery and above 2 years of age. The study excluded trauma patients, severely ill patients, morbidly ill patients, and those under 2 years old patients. The study involved subjects from the Department of Neurosurgery at King George's Medical University, Lucknow. Intraoperative neuromonitoring was performed using the Medtronic Nim-Eclipse System. MEP was used to monitor the functional integrity of corticospinal tracts by stimulating the patient's motor cortex transcranially and recording the activity in selected muscles.

Results: Out of 132, a total of 75 (59.09%) patients were male and 57 (40.91%) patients were female. Patient distribution is based on age group, with ≤20 years being the most common age group, followed by 21-30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years, respectively. The neurological impairments observed after surgery in the form of MEP waveforms. Of the 39 patients, 2 individuals (5.13%) had neurological impairment at the end of the procedure.

Conclusion: The study suggests that monitoring evoked potentials can detect and address neurological issues, improve postoperation function, and enhance patient safety and surgical outcomes in neurosurgery. It emphasizes the importance of MEP monitoring for assessing motor pathway integrity and recommends further studies with larger cohorts.