Unlike the actual motor grade of the patient, the MEP waveform is often measured in the operating room under general anesthesia. If the MEP waveform is measured smaller than the moror grade, it can be thought that it is due to the muscle relaxant. Why is the MEP waveform measured very smoothly even though the moror grade is very bad?
It seems to be different for Braintumor and Spine surgery.
Sang-Ku Park MEP is a rapid way of determining the integrity of corticospinal tract during surgery. It might differ for brain tumor surgery and stroke vs spine surgery due to the fact that non-pyramidal pathways such as rubrospinal tract and small pyramidal tracts could contribute to the voluntary motor control without eliciting MEP response in the former group of patients. Similary, the presence of small pyramidal tacts in the lower limbs could also not completely rule out the voluntary motor control.
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