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Ronald R. Tasker and L. W. Organ

and Spiegel and Wycis 10 from stimulation of the midbrain in man. We are summarizing our observations of the human upper auditory pathway during stimulation of the brain stem for the purpose of locating lesions during stereotaxic surgery. Most of the operations from which these data were collected were performed for the relief of involuntary movement, with electrode penetrations between 11 and 18 mm from the midline. The rest, carried out for the relief of intractable pain, provided data from 0 to 11 mm laterally. Method Using our own two-stage stereotaxic

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Johann Klein, Timo Siepmann, Gabriele Schackert, Tjalf Ziemssen, and Tareq A. Juratli

given its different etiology, even if a neurovascular contact is additionally present. 2 , 8 , 13 Other therapies are mostly destructive procedures, such as rhizotomy by radiofrequency or glycerol, radiosurgery, balloon compression, or open partial rhizotomy (Dandy procedure). These procedures can be effective; however, they are associated with potentially permanent complications such as hypesthesia. 5 , 7 , 25 , 28 , 39 Alternatively, spinal cord stimulation, motor cortex stimulation, and deep brain stimulation have been used for the treatment of refractory facial

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Johann Klein, Timo Siepmann, Gabriele Schackert, Tjalf Ziemssen, and Tareq A. Juratli

neuralgia attributed to MS given its different etiology, even if a neurovascular contact is additionally present. 2 , 8 , 13 Other therapies are mostly destructive procedures, such as rhizotomy by radiofrequency or glycerol, radiosurgery, balloon compression, or open partial rhizotomy (Dandy procedure). These procedures can be effective; however, they are associated with potentially permanent complications such as hypesthesia. 5 , 7 , 25 , 28 , 39 Alternatively, spinal cord stimulation, motor cortex stimulation, and deep brain stimulation have been used for the

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David S. Hersh, Katherine N. Sanford, Kenneth Moore, and Frederick A. Boop

Transcript In this video, we describe a midline, suboccipital approach with the use of intraoperative direct stimulation to identify and preserve functional tissue during the resection of a dorsally exophytic medullary tumor. 0:37 History The patient was a 5-year-old female who was initially referred for scoliosis. Imaging was performed during the course of her workup, revealing a dorsally exophytic medullary tumor extending into the cisterna magna. 0:53 Preop imaging T1- and T2-weighted MRI sequences demonstrated a 2.1 × 2.6 × 2.8–cm enhancing lesion arising

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Laura M. Muncie, Nathaniel R. Ellens, Emeline Tolod-Kemp, Claudio A. Feler, and John S. Winestone

C omplex regional pain syndrome (CRPS) is a neuropathic pain condition characterized by disturbances of sensory, motor, and autonomic function that may be associated with trophic changes. 8 Classic symptoms include intractable burning pain often exacerbated by emotional distress, light touch, movement of the affected extremity, or changes in temperature. 8 CRPS I is defined as pain only, while CRPS II is defined as pain with neurological deficit. 24 Spinal cord stimulation (SCS) is a surgical technique used to treat chronic pain disorders such as CRPS

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Shuji Sakata, Fumio Shima, Motohiro Kato, and Masashi Fukui

I t has been demonstrated clinically that electrical stimulation of various sites of the brain, such as the periaqueductal gray matter (PAG), 18, 35, 44 the thalamic somatosensory relay nucleus (ventroposterolateral nucleus, VPL), 9, 18, 40 and the medial thalamic nuclei including periventricular gray matter (PVG) 8, 9, 35, 44 and centromedian-parafascicular complex, 3, 8, 38 are effective in relieving intractable pain. Studies on laboratory animals have also demonstrated a reduction in aversive reactions indicative of pain following electrical stimulation

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Collin J. Larkin, Ketan Yerneni, Constantine L. Karras, Zachary A. Abecassis, Guangyu Zhou, Christina Zelano, Ashley N. Selner, Jessica W. Templer, and Matthew C. Tate

A wake craniotomy is the gold standard for maximizing extent of resection (EOR) for intracranial lesions located near or in eloquent areas of the brain. 1 Along with this technique, functional mapping with bipolar stimulation is used to better delineate diseased tissue from functional brain parenchyma. 2 This allows for better preservation of neurological function and decreased morbidity following surgery. 3 Intraoperative seizures (ISs), afterdischarges (ADs; defined as repetitive epileptiform discharges provoked by a stimulus), and changes in

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Elisabeth Kaufmann, Kai Bötzel, Christian Vollmar, Jan-Hinnerk Mehrkens, and Soheyl Noachtar

D eep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT) was approved in 2010 in Europe and in 2018 in the United States for the treatment of adult patients with drug-resistant focal-onset epilepsy syndromes. It was established as a safe and well-tolerated third-line therapy option for patients in whom surgery or vagus nerve stimulation (VNS) fails or those who are not candidates for surgery due to unknown or multiple seizure origins. 1–3 Its antiepileptic effect is based on the inhibition of seizure generalization, i.e., seizure

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Elisabeth Kaufmann, Kai Bötzel, Christian Vollmar, Jan-Hinnerk Mehrkens, and Soheyl Noachtar

D eep brain stimulation (DBS) targeting the anterior nucleus of the thalamus (ANT) was approved in 2010 in Europe and in 2018 in the United States for the treatment of adult patients with drug-resistant focal-onset epilepsy syndromes. It was established as a safe and well-tolerated third-line therapy option for patients in whom surgery or vagus nerve stimulation (VNS) fails or those who are not candidates for surgery due to unknown or multiple seizure origins. 1–3 Its antiepileptic effect is based on the inhibition of seizure generalization, i

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Daniele Starnoni, Giulia Cossu, Rodolfo Maduri, Constantin Tuleasca, Mercy George, Raphael Maire, Mahmoud Messerer, Marc Levivier, Etienne Pralong, and Roy T. Daniel

positioned for the recording of BAEPs, with a shorter latency. We explored the possibility of directly stimulating the cochlear nerve in our surgical cohort of large VSs, with recording electrodes placed at Cz and A1/A2 ( Fig. 1B ). FIG. 1. A: Image of a cadaveric specimen in which a right suboccipital scalp flap is reflected to expose the suboccipital muscles and the posterior auricular muscle. The posterior auricular muscle consists of 2 or 3 fleshy fasciculi that arise from the mastoid part of the temporal bone by short aponeurotic fibers. They insert into the