Neurophysiology in Neurosurgery

Vedran Deletis, MD, PhD is the former Director of the Intraoperative Neurophysiology Department in St. Luke’s/Roosevelt Hospital and an Associate Professor at the Albert Einstein College of Medicine in New York. Dr. Deletis is the founder of the International Society for Intraoperative Neurophysiology (ISIN) and served as its first president. Afar he completed his doctoral thesis in Clinical Neurophysiology and for the last 25 years he has dedicated his career to the field of Intraoperative Neurophysiology (ION). He established a fellowship program for ION in New York in which so far 20 fellows have participated, and have successfully implemented their acquired knowledge and experience in their respective countries. He has published numerous papers in the basic field of ION, especially on ION of the motor system. Jay L. Shils, Ph.D., D.ABNM, FASNM, FACNS is currently the director of intraoperative neurophysiological monitoring at Rush University Medical School and an Associate Professor in the department of Anesthesiology at Rush Medical Center. He received his Bachelor of Science degree in electrical engineering from Syracuse University, and both his masters and PhD in Bio-Engineering at The University of Pennsylvania using with his thesis dissertation subject – “The Bispectrum of the Human Electroencephalogram” to investigate interactions in the visual system and study EEG in epilepsy. Dr. Shils has been involved in intraoperative neuromonitoring since 1994 specializing in microelectrode neurophysiology for movement disorders. Dr. Shils is the co-editor of two neuromodulation related books which is one of his primary interests and the first edition of this book. Dr, Shils is a past president of the ASNM and the ISIN and is the founding secretary of the ISIN. Dr. Shils is the present secretary of the ASNM. Over the years Dr. Shils has presented at over 100 national and international has published on MER, DBS, neuromodulation, and intraoperative monitoring techniques. Francesco Sala is Professor and Chair of Neurosurgery at the University of Verona, in Italy. His main clinical and research interests are Pediatric Neurosurgery and Intraoperative Neurophysiology. In 1998-1999 he was Clinical Fellow in Intraoperative Neurophysiology, under the supervision of Dr. Vedran Deletis, at the Institute for Neurology and Neurosurgery in New York. Upon his return to Italy, he established the Intraoperative Neurophysiology Unit at the Institute of Neurosurgery in Verona where, in the past twenty years, more than 3000 elective neurosurgical procedures have been performed under neurophysiological guidance. In 2005 he was one of the co-founders of the International Society for Intraoperative Neurophysiology, where he has served as Secretary (2009-2011), Chairman of the Education Committee (2011-2013), and President (2013-2015). Prof. Sala is particularly committed to the training of young neurosurgeons and the development of intraoperative neurophysiology in the global neurosurgical community. Since 2010 he teaches at the Training Courses of the European Association of Neurosurgical Societies (EANS), and he’s currently an Executive Board member of the EANS. In 2016 he was appointed as first Chair of the Neuromonitoring Committee of the World Federation of Neurosurgical Societies. Kathleen Seidel, is board certified neurosurgeon, staff physician and associate professor of the Department of neurosurgery at the Inselspital, University Hospital Bern, Switzerland. Since 2008 at the Inselspital, she has established the unit of intraoperative neurophysiology. After a fellowship in ION with Vedran Deletis in New York, she is providing training to other professionals, hosting international observers and focusing on advance of ION modalities to improve patient safety in technical high-risk surgeries. Providing expertise in neurosurgery and intraoperative neurophysiology, she is a routinely invited speaker at international courses and congresses. She has published numerous ION papers and key papers concerning subcortical brain mapping and mapping of the spinal cord. Currently, she serves as the head of the scientific committee of the society of intraoperative neurophysiology (ISIN). Recently, she was awarded with the prestigious Theodor Kocher Prize of Bern University, which honors its best academics across its faculties for their exceptional and innovative scientific achievements.

PART I: Introduction to Intraoperative Neurophysiology a. Historical perspective

PART II: Intraoperative Neurophysiology: Neurophysiological perspective a. Neurophysiology of the motor system: basics and IOM techniques b. Neurophysiology of the somatosensory system: basics and IOM techniques c. Neurophysiology of the auditory system: basics and IOM techniques d. Neurophysiology of the visual system: basics and IOM techniques e. Neurophysiology of language and other cognitive systems f. Neurophysiology of critical brainstem and spine reflexes

PART III: Safety and Anesthesia in Intraoperative Neurophysiology a. Safety b. Principles of Anesthesia

PART IV: Intraoperative Neurophysiology: Surgical perspective a. Supratentorial surgery b. Infratentorial surgery c. Spine and Spinal Cord Surgery d. Surgery of the Peripheral Nervous System e. Vascular Neurosurgery f. Functional Neurosurgery

Part V: Conclusions on current challenges of neuromonitoring a. Analysis of Costs and Benefits b. Evidence Based Medicine and Intraoperative Neurophysiology c. Current trends and threats