Ann Rehabil Med.  2018 Apr;42(2):352-357. 10.5535/arm.2018.42.2.352.

Intraoperative Monitoring of Hypoglossal Nerve Using Hypoglossal Motor Evoked Potential in Infratentorial Tumor Surgery: A Report of Two Cases

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea. hangil_seo@snuh.org
  • 2Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.

Abstract

The hypoglossal nerve (CN XII) may be placed at risk during posterior fossa surgeries. The use of intraoperative monitoring (IOM), including the utilization of spontaneous and triggered electromyography (EMG), from tongue muscles innervated by CN XII has been used to reduce these risks. However, there were few reports regarding the intraoperative transcranial motor evoked potential (MEP) of hypoglossal nerve from the tongue muscles. For this reason, we report here two cases of intraoperative hypoglossal MEP monitoring in brain surgery as an indicator of hypoglossal deficits. Although the amplitude of the MEP was reduced in both patients, only in the case 1 whose MEP was disappeared demonstrated the neurological deficits of the hypoglossal nerve. Therefore, the disappearance of the hypoglossal MEP recorded from the tongue, could be considered a predictor of the postoperative hypoglossal nerve deficits.

Keyword

Intraoperative monitoring; Motor evoked potentials; Hypoglossal nerve

MeSH Terms

Brain
Electromyography
Evoked Potentials, Motor*
Humans
Hypoglossal Nerve*
Infratentorial Neoplasms*
Monitoring, Intraoperative*
Muscles
Tongue
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