• Mark A Burbridge, Viet Nguyen, Jung Gi Min, Richard A Jaffe, Brian Ahuja, Amit D Shah, Leslie H Lee, Charles Cho, Breanna Sandoval, and Jaime R López.
• Departments of Anesthesiology, Perioperative and Pain Medicine.
• J Neurosurg Anesthesiol. 2021 Oct 1; 33 (4): 351-355.

BackgroundIntraoperative neurophysiological monitoring is of critical importance in evaluating the functional integrity of the central nervous system during surgery of the central or peripheral nervous system. In a large recent study, transcranial motor-evoked potentials (TcMEPs) were found to be associated with a 0.7% risk of inducing a seizure as diagnosed by clinical observation and electromyography in patients having general anesthesia with intravenous anesthetics. The gold standard for seizure diagnosis, however, is electroencephalography (EEG). The aim of this single-institution retrospective study is to ascertain the risk of intraoperative seizures detected using EEG during surgeries in adult patients undergoing intraoperative monitoring with TcMEPs.MethodsThe authors retrospectively reviewed the intraoperative EEG records of 1175 patients anesthetized with a variety of anesthetic agents, including volatile and intravenous anesthetics, to ascertain the rate of EEG-diagnosed seizures attributable to TcMEPs.ResultOur analysis did not reveal a single seizure event attributable to TcMEPs in 1175 patients.ConclusionThe intraoperative use of TcMEPs does not seem to cause seizures.Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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