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Intracranial electrical recording is a useful neurophysiologic tool in presurgical evaluation in epilepsy and brain tumor surgery. However, few studies have described the utility of intraoperative cerebral monitoring in amyotrophic lateral sclerosis (ALS). We present a patient with ALS who underwent an ipsilateral frontotemporal lobectomy under intraoperative cortical electrical recording. We performed a review of the literature in PubMed and Embase databases for patients who underwent an intraoperative evaluation of function in ALS. We found that in 12 cases (13 patients), a frontotemporal lobectomy or amygdalohippocampectomy was performed under intraoperative electrical monitoring. In all cases, an early decrease of brainstem auditory evoked potentials (BAEPs), auditory steady-state response (ASSR) waveforms, and cortical activity was observed. General anesthesia was not necessary in most cases (62%); in the remaining cases, anesthesia was induced by propofol and maintained with remifentanil and sevoflurane inhalation. A total of 15 patients survived more than 1 year after operation. The mean interval between the first and last neuromuscular monitoring was 5.5 years (range 3-13 years). All patients had good or excellent postoperative recovery of functional deficit, whereas five of them also had postoperative atrophy of the reconstructed motor area, indicating a poor recovery of corticospinal tract fibers. In patients with ALS, cerebral electrical monitoring is useful to assess the functional status of the brain cortex during surgery. The waveforms can help predict functional recovery of the cortex after a partial or subtotal resection.Variations in the structure of rat ejaculated spermatozoa during ejaculation and in vitro.
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