[Transcranial motor evoked potentials in resection of supratentorial brain tumors adjacent to corticospinal tract in children].
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BACKGROUND: Transcranial motor evoked potentials (TMEPs) are one of the methods allowing functional preservation of motor pathways in resection of tumors adjacent to corticospinal tract. Studies of this method in pediatric neurosurgery note some difficulties in data interpretation, but most demonstrate high efficacy even in younger children. OBJECTIVE: To determine the role of TMEPs in surgical treatment of children with supratentorial tumors adjacent to corticospinal tract. MATERIAL AND METHODS: There were 82 patients with intracerebral tumors who underwent 95 surgeries between January 2016 and December 2023. Age ranged from 6 months to 18 years. The study included patients with tumors of various hemispheric localizations, including deep neoplasms (57 patients). TMEPs were used in all patients. RESULTS: Topography and histology of gliomas have no effect on stability of TMEPs at the beginning of surgery. Preoperative motor impairments significantly affect the amplitude and reproducibility of TMEPs. Age did not affect the amplitude of potentials, but reduced reproducibility was more common in children younger 5 years. CONCLUSION: Preoperative motor impairments are the leading cause of TMEP instability. Intraoperative dynamics of TMEPs predicts long-term functional outcomes. Partial or complete intraoperative reduction of TMEPs is a prognostically unfavorable factor for motor function recovery.