Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Klinisches Neurowissenschaften Zentrum, Universität Zürich, Switzerland.
Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland; Klinisches Neurowissenschaften Zentrum, Universität Zürich, Switzerland.
Clin Neurophysiol. 2022 Jun;138:148-152. doi: 10.1016/j.clinph.2022.03.016. Epub 2022 Mar 28.
Intraoperative transcranial electrical stimulation evokes a motor response at short latency (SLR) of a few milliseconds in cranial nerves innervated muscles. In addition, a long latency response (LLR) is known for the laryngeal nerve. We present here the LLR in the tongue muscles.
In 22 neurosurgical interventions we have applied electrical stimulation pulses transcranially over the motor cortex of fully anesthetized patients. Stimulation sites were lateral (C3/C4 - Cz) or medial (C1-C2). We recorded motor evoked potentials from the tongue as the target muscle of the hypoglossal nerve.
Stimulation evoked a SLR of the tongue with a median (IQR) latency of 14 (13, 19) ms. In addition, a LLR appeared at 58 (54, 66) ms. Median (IQR) response amplitudes were 60 (32, 185) μV for SLR and 30 (20, 47) μV for LLR. While stimulation by C3/C4 - Cz evoked both the SLR and the LLR, stimulation by C1-C2 evoked preferably the LLR with a success rate of 16/18 (89%) surgeries (p =.0007).
Transcranial electrical stimulation robustly elicits a LLR in the tongue muscles of anesthetized patients.
We corroborated preliminary findings on the LLR of the tongue muscles in more patients.
在颅神经支配的肌肉中，经颅电刺激可引发潜伏期较短（SLR）的运动反应，潜伏期为数毫秒。此外，喉返神经的潜伏期较长（LLR）也为人们所熟知。我们在此介绍舌肌的 LLR。
在 22 例接受全身麻醉的神经外科手术中，我们经颅施加电刺激脉冲。刺激部位为外侧（C3/C4-Cz）或内侧（C1-C2）。我们记录了舌肌作为舌下神经靶肌肉的运动诱发电位。
刺激引发了舌肌的 SLR，潜伏期中位数（IQR）为 14（13，19）ms。此外，还出现了潜伏期为 58（54，66）ms 的 LLR。SLR 的中位数（IQR）反应幅度为 60（32，185）μV，LLR 的中位数（IQR）反应幅度为 30（20，47）μV。C3/C4-Cz 刺激可引发 SLR 和 LLR，而 C1-C2 刺激则更倾向于引发 LLR，成功率为 16/18（89%）（p=0.0007）。
经颅电刺激可在麻醉患者的舌肌中可靠地引发 LLR。
我们在更多患者中证实了舌肌 LLR 的初步发现。
