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Effects of intravenous methylprednisolone on intraoperative neurophysiological monitoring during spinal cord tumor surgery: a case report

 Dae Geun Jeon  ;  Yoon Ghil Park  ;  Yong Eun Cho  ;  Dawoon Kim  ;  Jinyoung Park 
 Journal of Intraoperative Neurophysiology (수술중신경계감시학회지), Vol.1(2) : 50-54, 2019-06 
Journal Title
 Journal of Intraoperative Neurophysiology (수술중신경계감시학회지) 
Issue Date
methylprednisolone ; intraoperative neurophysiological monitoring ; spinal cord tumor
In spinal cord tumor surgery, muscle motor-evoked potentials (mMEPs) and direct wave (D-wave) have been used to predict neurological outcomes. A severe deterioration of mMEPs in the presence of intact D-wave may indicate temporary postoperative weakness. A 58-year-old man complaining of lower extremities’ weakness was diagnosed as cavernous malformation at T3/T4 level. During removal surgery, the amplitudes of mMEPs were reduced more than 80% in the right tibialis anterior and abductor halluces compared to the baseline in the absence of a change in D-wave. After administration of high-dose intravenous methylprednisolone (IVMP), the D-wave considerably amplified while the mMEPs did not change. The postoperative motor score was increased. This is the first report of the large amplification of D-waves immediately after administration of IVMP. It is suggestive that perioperative administration of high-dose IVMP immediately after the detection of the significant reduction of mMEPs amplitudes may improve neural conduction during spinal cord surgery.
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1. College of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoon Ghil(박윤길) ORCID logo https://orcid.org/0000-0001-9054-5300
Park, Jinyoung(박진영) ORCID logo https://orcid.org/0000-0003-4042-9779
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
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