Persistent hemiplegia with normal intraoperative neurophysiological monitoring in supratentorial neurosurgery: a case report and review of literature

Intraoperative neurophysiological monitoring (IONM) is needed for evaluating and demonstrating the integrity of the central and peripheral nervous system during surgical manoeuvres that take place in proximity to eloquent motor and somatosensory nervous structures. The integrity of the monitored mot...

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Bibliographic Details
Published in:Neurological sciences 2024, Vol.45 (1), p.119-127
Main Authors: Stipa, Giuseppe, Muti, Marco, Ciampini, Alessandro, Frondizi, Domenico, Rossi, Vera, Fanelli, Cinzia, Conti, Carlo
Format: Article
Language:English
Subjects:
Brain
Case reports
Edema
Evoked Potentials, Motor - physiology
Glioblastoma
Hemiplegia
Hemiplegia - etiology
Hemiplegia - surgery
Hospitals
Humans
Intraoperative Neurophysiological Monitoring
Medical prognosis
Medicine
Medicine & Public Health
Nervous system
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Neurosurgical Procedures - adverse effects
Paralysis
Patients
Psychiatry
Review Article
Surgery
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Summary:Intraoperative neurophysiological monitoring (IONM) is needed for evaluating and demonstrating the integrity of the central and peripheral nervous system during surgical manoeuvres that take place in proximity to eloquent motor and somatosensory nervous structures. The integrity of the monitored motor pathways is not always followed by consistent clinical normality, particularly in the first hours/days following surgery, when surgical resection involves brain structures such as the supplementary motor areas (SMA). We report the case of a patient who underwent surgical excision of a right frontal glioblastoma with normal preoperative, intraoperative (IONM), and postoperative central motor conduction, but with persistent postoperative hemiplegia (> 6 months). The literature regarding SMA syndrome and its diagnosis and prognosis is reviewed.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-023-07022-1