Intra Operative NeuroPhysiological Monitoring- IONM

IONM for Posterior Fossa & Brainstem surgery, most brain surgery related IONM functional assessments use time tested Auditory Evoked Potentials or BAER along with Cranial nerve responses, also monitored is EMGs as routine. Here is an interesting procedure in which the group utilized Laryngeal adductor reflex (LAR) & Motor Evoked Potentials of Vocal Muscles (CoMEP), continuous monitoring of LAR (LAR:-to assess both sensory and motor activities of Vagus nerve (Yes, you heard me right, Vagus is an exceptional cranial nerve that possess both sensory and motor fibers (besides 3 other CNs that are both motor and sensory, check the list of CNs and nerve complex in the Netters image below). as against carrying only one type either sensory or motor fibers in the cases of other cranial nerves!?). Total 53 patients underwent Cerebellar pontine angle and Brainstem surgeries, LAR and CoMEP responses continuously guided the surgeons, when abnormal activity or response was reported, the su

In the absence of lower motor potentials in ALS patients, bilateral upper limbs evoked potentials can be used to assess the motor functions..!. In this Article: Upper limb motor evoked potentials as outcome measure in progressive multiple sclerosis