Pediatric Intraoperative Neurophysiologic Mapping and Monitoring in Brain Surgery.

Journal

Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society

ISSN: 1537-1603

Titre abrégé: J Clin Neurophysiol

Pays: United States

ID NLM: 8506708

Informations de publication

Date de publication:
01 Feb 2024

Historique:

medline: 2 2 2024

pubmed: 2 2 2024

entrez: 2 2 2024

Statut: ppublish

Résumé

Similar to adults, children undergoing brain surgery can significantly benefit from intraoperative neurophysiologic mapping and monitoring. Although young brains present the advantage of increased plasticity, during procedures in close proximity to eloquent regions, the risk of irreversible neurological compromise remains and can be lowered further by these techniques. More so, pathologies specific to the pediatric population, such as neurodevelopmental lesions, often result in medically refractory epilepsy. Thus, their successful surgical treatment also relies on accurate demarcation and resection of the epileptogenic zone, processes in which intraoperative electrocorticography is often employed. However, stemming from the development and maturation of the central and peripheral nervous systems as the child grows, intraoperative neurophysiologic testing in this population poses methodologic and interpretative challenges even to experienced clinical neurophysiologists. For example, it is difficult to perform awake craniotomies and language testing in the majority of pediatric patients. In addition, children may be more prone to intraoperative seizures and exhibit afterdischarges more frequently during functional mapping using electrical cortical stimulation because of high stimulation thresholds needed to depolarize immature cortex. Moreover, choice of anesthetic regimen and doses may be different in pediatric patients, as is the effect of these drugs on immature brain; these factors add additional complexity in terms of interpretation and analysis of neurophysiologic recordings. Below, we are describing the modalities commonly used during intraoperative neurophysiologic testing in pediatric brain surgery, with emphasis on age-specific clinical indications, methodology, and challenges.

Identifiants

DOI: 10.1097/WNP.0000000000001054 PMID: 38306217

pubmed: 38306217

doi: 10.1097/WNP.0000000000001054

pii: 00004691-202402000-00002

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

96-107

Informations de copyright

Déclaration de conflit d'intérêts

The authors have no funding or conflicts of interest to disclose.

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