• Dougho Park, Dong Young Kim, Yoon Sik Eom, Sang-Eok Lee, and Seung Bum Chae.
• Department of Rehabilitation Medicine.
• Medicine (Baltimore). 2021 Feb 26; 100 (8): e24702e24702.

RationaleIntraoperative neurophysiological monitoring (IONM) has been utilized not only for the rapid detection of neural insults during surgeries, but also to verify the neurophysiological integrity of nerve lesions in the surgical field.Patient ConcernsA 32-year-old woman presented with a wrist and finger drop that had lasted about 3 months.DiagnosesThe result of the initial electrodiagnostic test was consistent with posterior interosseous nerve (PIN) syndrome. Ultrasonography and magnetic resonance imaging of the proximal forearm showed a cystic mass at the anterolateral aspect of the radial head, which was diagnosed as a ganglion cyst.InterventionsSurgical release of the ganglion cyst with IONM was performed. During the surgery, we induced nerve action potentials and compound motor action potentials across the ganglion cyst, which demonstrated neural continuity.OutcomesThree months after the surgery, the patient showed partial recovery of wrist and finger extensor muscle power. An electrodiagnostic test conducted 3 months after the surgery showed reinnervation potentials in PIN-innervated muscles.LessonsIONM during peripheral nerve surgeries can support surgical decisions and confirm the location and degree of nerve damage.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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