Predictive value of intraoperative neurophysiologic monitoring in detecting new postoperative neurological deficits

Solapas principales

Pérez P.1., Quintanilla B.2., Alvarez L.3., Mejía M.2.



            Intraoperative neurophysiological monitoring (IONM) in most of the studies has shown that it can detect and prevent new neurological deficit again (NND) with reasonable sensitivity and specificity.

A prospective study of 16 patients undergoing neurosurgical procedures, applying standardized protocols IONM, classifying them into groups of predictability values ​​according to the neurophysiological events were found.

The mean age was 36.7 + / -21.8 years, 68.8% of injuries were infratentorial brain tumor, the rest to the cervical spinal cord of which, 18.7% were extramedullary and 12.5% ​​intramedullary. Of the 4 patients with NND, 3 were detected with IONM, and 1 case was a false negative, having a sensitivity of 75%, the negative predictive value was 83.3%, the positive predictive value was 80%, and specificity of 71.4%.

One should consider in the analysis of the effectiveness of neurophysiological monitoring, not only changes in evoked potentials (EPs) and postoperative condition of the patient, but also measures followed a deterioration of Pes, to help prevent neurological deterioration patient that occurs in the majority of cases in which the surgeon reacts to neurophysiological alarm event.



Key Words: Predictive value, intraoperative monitoring, neurological deficit, sensitivity specificity.



  1. Servicio de Neurofisiología, Hospital Miguel Grau – EsSalud, Lima – Perú
  2. Departamento Neurocirugía, Hospital Guillermo Almenara – EsSalud, Lima – Perú
  3. Departamento Neurocirugía, Hospital Edgardo Rebagliati – EsSalud, Lima – Perú