Abstract and Keywords
Transcranial electrical stimulation is a well-recognized method for corticospinal tract (CT) activation. This article explains the use of TES during surgery and highlights the physiology of the motor-evoked potentials (MEPs). It describes the techniques and methods for brain stimulation and recording of responses. There are two factors that determine the depth of the current penetrating the brain, they are: choice of electrode montage for stimulation over the scalp and the intensity of stimulation. D-wave collision technique is a newly developed technique that allows mapping intraoperatively and finding the anatomical position of the CT within the surgically exposed spinal cord. Different mechanisms may be involved in the pathophysiology of postoperative paresis in brain and spinal cord surgeries so that different MEP monitoring criteria can be used to avoid irreversible damage and accurately predict the prognosis.
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