Intraoperative Flash VEPs Are Reproducible in the Presence of Low Amplitude EEG

Overview

Journal J Clin Monit Comput

Publisher Springer

Specialties Anesthesiology
General Medicine
Medical Informatics

Date 2013 Nov 16

PMID 24233355

Citations 6

Authors

David A Houlden

Chantal A Turgeon

Thomas Polis

John Sinclair

Stuart Coupland

Pierre Bourque

Martin Corsten

Amin Kassam

Affiliations

Soon will be listed here.

Abstract

Flash visual evoked potentials (FVEPs) are often irreproducible during surgery. We assessed the relationship between intraoperative FVEP reproducibility and EEG amplitude. Left then right eyes were stimulated by goggle light emitting diodes, and FVEPs were recorded from Oz–Fz′ (International 10-20 system) in 12 patients. Low cut filters were ≤5 Hz in all patients; two patients also had recordings using 10 and 30 Hz. The reproducibility of FVEP and the amplitude of the concomitant EEG from C4′–Fz were measured. Nine patients had low amplitude EEG (<30 μV); reproducible FVEPs were obtained from all eyes with normal pre-operative vision. The other three patients had high amplitude EEG (>50 μV); FVEPs were absent from three of four eyes with normal pre-operative vision (the other normal eye had a present but irreproducible FVEP). Raising the low cut filter to 10 and 30 Hz (in two patients) progressively reduced EEG and FVEP amplitude, reduced amplifier blocking time and improved FVEP reproducibility. FVEPs were more reproducible in the presence of low amplitude EEG than high amplitude EEG. This is the first report describing the effect of EEG amplitude on FVEP reproducibility during surgery

Citing Articles

Intraoperative Monitoring of Sensory Evoked Potentials in Neurosurgery: A Personalized Approach.

Levin E J Pers Med. 2025; 15(1).

PMID: 39852218 PMC: 11766474. DOI: 10.3390/jpm15010026.

Reliability of intraoperative visual evoked potentials (iVEPs) in monitoring visual function during endoscopic transsphenoidal surgery.

Mattogno P, DAlessandris Q, Rigante M, Granata G, di Domenico M, Perotti V Acta Neurochir (Wien). 2023; 165(11):3421-3429.

PMID: 37733080 PMC: 10624729. DOI: 10.1007/s00701-023-05778-1.

Evolution of flash visual evoked potentials to monitor visual pathway integrity during tumor resection: illustrative cases and literature review.

Olmsted Z, Silverstein J, Einstein E, Sowulewski J, Nelson P, Boockvar J Neurosurg Rev. 2023; 46(1):46.

PMID: 36715828 DOI: 10.1007/s10143-023-01955-z.

Effect of remimazolam on intraoperative neurophysiology monitoring of visual-evoked potential: a case series.

Yamada S, Hayamizu K, Akiyama Y, Kimura Y, Hashimoto S, Mikuni N J Anesth. 2023; 37(2):311-314.

PMID: 36602625 DOI: 10.1007/s00540-022-03159-z.

Comparison of the effect of sedation and general anesthesia on pattern and flash visual evoked potentials in normal dogs.

Chang S, Zwueste D, Ambros B, Norton J, Leis M BMC Vet Res. 2022; 18(1):272.

PMID: 35831819 PMC: 9277965. DOI: 10.1186/s12917-022-03375-5.

References

Nuwer M, DAWSON E . Intraoperative evoked potential monitoring of the spinal cord. A restricted filter, scalp method during Harrington instrumentation for scoliosis. Clin Orthop Relat Res. 1984; (183):42-50. View

Sebel P, Ingram D, Flynn P, Rutherfoord C, Rogers H . Evoked potentials during isoflurane anaesthesia. Br J Anaesth. 1986; 58(6):580-5. DOI: 10.1093/bja/58.6.580. View

Cedzich C, Schramm J, Fahlbusch R . Are flash-evoked visual potentials useful for intraoperative monitoring of visual pathway function?. Neurosurgery. 1987; 21(5):709-15. DOI: 10.1227/00006123-198711000-00018. View

Ota T, Kawai K, Kamada K, Kin T, Saito N . Intraoperative monitoring of cortically recorded visual response for posterior visual pathway. J Neurosurg. 2009; 112(2):285-94. DOI: 10.3171/2009.6.JNS081272. View

Zaarour C, Engelhardt T, Strantzas S, Pehora C, Lewis S, Crawford M . Effect of low-dose ketamine on voltage requirement for transcranial electrical motor evoked potentials in children. Spine (Phila Pa 1976). 2007; 32(22):E627-30. DOI: 10.1097/BRS.0b013e3181573eb4. View

Cedzich C, Schramm J . Monitoring of flash visual evoked potentials during neurosurgical operations. Int Anesthesiol Clin. 1990; 28(3):165-9. DOI: 10.1097/00004311-199002830-00006. View

Wiedemayer H, Fauser B, Armbruster W, Gasser T, Stolke D . Visual evoked potentials for intraoperative neurophysiologic monitoring using total intravenous anesthesia. J Neurosurg Anesthesiol. 2002; 15(1):19-24. DOI: 10.1097/00008506-200301000-00004. View

Skuse N, Burke D . Power spectrum and optimal filtering for visual evoked potentials to pattern reversal. Electroencephalogr Clin Neurophysiol. 1990; 77(3):199-204. DOI: 10.1016/0168-5597(90)90038-f. View

Odom J, Bach M, Brigell M, Holder G, McCulloch D, Tormene A . ISCEV standard for clinical visual evoked potentials (2009 update). Doc Ophthalmol. 2009; 120(1):111-9. DOI: 10.1007/s10633-009-9195-4. View

10.

Banoub M, Tetzlaff J, Schubert A . Pharmacologic and physiologic influences affecting sensory evoked potentials: implications for perioperative monitoring. Anesthesiology. 2003; 99(3):716-37. DOI: 10.1097/00000542-200309000-00029. View

11.

. American Electroencephalographic Society guidelines for intraoperative monitoring of sensory evoked potentials. J Clin Neurophysiol. 1987; 4(4):397-416. View

12.

Rampil I, Lockhart S, Eger 2nd E, Yasuda N, Weiskopf R, Cahalan M . The electroencephalographic effects of desflurane in humans. Anesthesiology. 1991; 74(3):434-9. DOI: 10.1097/00000542-199103000-00008. View

13.

Huotari A, Koskinen M, Suominen K, Alahuhta S, Remes R, Hartikainen K . Evoked EEG patterns during burst suppression with propofol. Br J Anaesth. 2003; 92(1):18-24. DOI: 10.1093/bja/aeh022. View

14.

Tinker J, Sharbrough F, Michenfelder J . Anterior shift of the dominant EEG rhytham during anesthesia in the Java monkey: correlation with anesthetic potency. Anesthesiology. 1977; 46(4):252-9. DOI: 10.1097/00000542-197704000-00005. View

15.

Chi O, McCoy C, Field C . Effects of fentanyl anesthesia on visual evoked potentials in humans. Anesthesiology. 1987; 67(5):827-30. DOI: 10.1097/00000542-198711000-00040. View

16.

Murphy M, Bruno M, Riedner B, Boveroux P, Noirhomme Q, Landsness E . Propofol anesthesia and sleep: a high-density EEG study. Sleep. 2011; 34(3):283-91A. PMC: 3041704. DOI: 10.1093/sleep/34.3.283. View

17.

. Guideline 9B: Guidelines on visual evoked potentials. J Clin Neurophysiol. 2006; 23(2):138-56. DOI: 10.1097/00004691-200604000-00011. View

18.

You Y, Thie J, Klistorner A, Gupta V, Graham S . Normalization of visual evoked potentials using underlying electroencephalogram levels improves amplitude reproducibility in rats. Invest Ophthalmol Vis Sci. 2012; 53(3):1473-8. DOI: 10.1167/iovs.11-8797. View

19.

Cohen B, Baldwin M . Visual-evoked potentials for intraoperative neurophysiology monitoring: another flash in the pan?. J Clin Neurophysiol. 2011; 28(6):599-601. DOI: 10.1097/WNP.0b013e31823da5c1. View

20.

Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H . Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg. 2009; 112(2):273-84. DOI: 10.3171/2008.9.JNS08451. View