Neuromonitoring
Neuromonitoring refers to the continuous or periodic monitoring of physiological parameters related to the nervous system. The goal of neuromonitoring is to assess the function and integrity of the nervous system in real-time, allowing clinicians to detect abnormalities or changes in neurological status and make timely decisions regarding patient care. This can be particularly important in critical care settings, surgeries involving the nervous system, or other situations where monitoring neurological function is crucial.
| Aspect | Neuromonitoring (IONM) | Multimodal Neuromonitoring (MMN) |
|---|---|---|
| Definition | The use of one neurophysiological technique to monitor nervous system function. | The simultaneous use of two or more neuromonitoring modalities. |
| Examples | * SSEPs during spine surgery<br>* EEG in carotid surgery | * SSEPs + MEPs + EMG in scoliosis surgery<br>* MEPs + mapping in glioma |
| Goal | Monitor a single functional system (e.g., sensory or motor). | Monitor multiple neural systems for broader safety. |
| Use Cases | * Low-risk spine procedures<br>* Resource-limited settings | * Complex brain/spinal surgeries<br>* Brainstem or eloquent cortex lesions |
| Sensitivity | Lower — may miss deficits if only one pathway is monitored. | Higher — cross-checking between modalities improves detection. |
| Personnel Required | Usually one technologist or neurophysiologist | Typically a team (tech + neurophysiologist + surgeon coordination) |
| Cost and Setup | Less resource-intensive | More equipment, time, and expertise required |