Phase Reversal SEP For Santral Sulcus Localization

Scientific Background: During surgeries near the motor cortex the sensori-motor cortex is commonly identified with anatomical markers by the surgeon. These surgeries may be associated with a high risk of motor deficits and preoperative functional magnetic resonance imaging, tractography, or intraoperative electrophysiological techniques such as phase reversal somatosensorial evoked potential (PR-SEP) monitoring and/or cortical stimulation methods may be used to decrease the rate of postoperative deficits. PR-SEP has been reported to be an easy and reliable technique to exactly localize the central sulcus.Objectives: The aim of this study is to report the results of PR-SEP studies performed in our enstitution in surgeries near the motor cortex.Material and Methods: Eleven male and 4 female patients with ages between 11-68 were monitorized with PR-SEP during the period of February 2006-2008 at Yeditepe University Hospital, Neurological Sciences Department.Results: In 13 patients (%86,6) the central sulcus was localized with PR-SEP, and none of our patients had a new postoperative motor deficit. In 2 patients (%13,3) the central sulcus localization was not successful.Conclusions: It has been reported that, PR-SEP is an easy method to localize the central sulcus and is successful in 80-90 % of the cases. Similarly in our study this method was succesfull in 86% of the patients. We conclude that as an addition to the preoperative imaging techniques and intraoperative anatomical localization, PR-SEP is an easy and reliable method to guide the surgeon for the surgeries near the motor cortex in order to decrease the postoperative motor deficits.