An intraoperative test of voluntary motor function. The patient is allowed to wake up enough from anesthesia to be able to wiggle the toes on command (the patient is kept intubated and the wound is not closed). Less commonly used in the current era of electrophysiologic monitoring (EPM), but may be employed in cases where EPM is felt to be possibly unreliable. And since no specialized equipment is required, it can be used in times or places where access to EPM is limited. Is more efficacious if planned in advance, in which case short-acting anesthetic agents are employed and the patient can be briefed ahead of time. Cons: can only be performed sparingly during surgery (time consuming and often challenging), so it may delay detection of any other change that might be identified earlier by EPM. Patients often will try to get up or move. Tests only motor function, and may miss subtle deficits.