Van Buren J M
J Neurosurg. 1983 Jul;59(1):119-30. doi: 10.3171/jns.1983.59.1.0119.
During the course of 134 craniotomies under local anesthesia, 274 sensory responses to electrical stimulation were recorded as to cortical site, type of sensation, and the site and lateralization of peripheral referral. The region of cortex exposed was largely the sensorimotor region near the Sylvian fissure and the temporal lobe. Differences in the type of sensation were seen on either side of the central fissure. Sensation of movement and specific sensations were reported more commonly from stimulation in the precentral region and crude sensation from the postcentral area. "Pain" was reported only once and taste not at all despite the large somatic sensory representation of the tongue. About 30% of the responses were referred to the ipsilateral side or bilaterally, with a somewhat higher percentage in the pre- than in the postcentral region. In general, the expected somatotopic sequence was followed, with tongue and mouth having the largest representation. An unexpected number of referrals to the head/face were found in the suprasylvian region, and it was uncertain whether this was part of Somatosensory area II. Eleven cases with sensory referrals to trunk/limbs in the suprasylvian area were found predominantly in the precentral region. No somatotopic pattern could be seen in these or on review of Penfield's material. Possible anatomical pathways for transmission of these responses were reviewed and questions raised as to the mechanisms involved.
在134例局部麻醉下的开颅手术过程中，记录了274次对电刺激的感觉反应，涉及皮质部位、感觉类型以及外周牵涉痛的部位和偏向。暴露的皮质区域主要是靠近外侧裂的感觉运动区和颞叶。在中央沟两侧可观察到感觉类型的差异。中央前区刺激更常报告运动感觉和特定感觉，中央后区刺激则更常报告粗略感觉。尽管舌部有大量的躯体感觉代表区，但“疼痛”仅被报告一次，而味觉根本未被报告。约30%的反应牵涉到同侧或双侧，中央前区的牵涉比例略高于中央后区。一般来说，遵循了预期的躯体定位顺序，舌部和口部的代表区最大。在外侧裂上区发现了意外数量的牵涉到头部/面部的反应，不确定这是否是躯体感觉区II的一部分。在外侧裂上区发现11例牵涉到躯干/肢体的感觉反应，主要集中在中央前区。在这些病例或回顾彭菲尔德的资料时均未发现躯体定位模式。对这些反应的可能解剖传导途径进行了回顾，并对其中涉及的机制提出了疑问。
