Monitoring

[garyw]

I need surgery for an ependimoma soon. I just talked to a neurosurgeon who was willing to do the surgery next month, but he would be using SEP monitoring but not MEP.
If I search out other neurosurgeons, it will undoubtedly be another several months to arrange for another surgeon to do it.
So I'm wondering how much of a risk would I be taking going with just the SEP monitoring?
Anybody else have just the SEP? And did everything go OK?
Any experiences or ideas about this much appreciated.
Gary

[tc]

Yikes, Gary. From all the research and reading I have done, you should have both SEPs and MEPs when they operate on your ependymoma. That's the standard. I would look for another neurosurgeon who uses both. I wouldn't risk it.
Teresa

[garyw]

"Yikes" is a good way to describe this all right! I decided to find out if the hospital involved actually HAD an MEP. It took a bit of digging and a number of phone calls but I finally found out from someone in the neuro dept that they DID have one but "it was not set up right , and they didn't know how to use it and they didn't know when it would be operational".
Ummmm.... OK, I think I'll give this hospital a pass!
So, I am going with another hospital, with a Dr and staff who are experienced with this important monitoring equipment.
I won't be getting the surgery quite as soon, but I will be much more confident that I'll be getting the best outcome possible.
Gary

[valerieb]

Gary I have to tell you that MEP is crucial and the neurophysiologist (I think this is his specialty name) at the conference concurred. As I understand it, and it was definitely vital for my surgery and recovery, the SEP may be responsive and you may still have full sensation BUT could still lose motor function; hence the need for MEP.

The sensory and motor pathways are separate and distince neuro pathways and must be monitored separately and for patients like us I don't think it is a wise decision to do anything less. I always view NS suspiciously who diminish the need for these safeguards. As the presenter at the conference said, 9 out of 10 times with a highly experienced NS they can do the surgery without the SEP/MEP and do it successfully. BUT would you, or any of us, want to be that 1 person who it saved from further damage? I know my NS stopped the surgery when my MEP went nuts; thankfully my NS is very highly skilled and had managed by that point to remove all of the tumor. I do have some sensory issues like we all do but for the most part my motor function is intact.

If I should ever have to undergo another surgery for this I would not hesitate to use the monitoring. It is also crucial to make sure that the medical professional who does the monitoring is not simply a technician working for a service that the hospital employs. They have specific disciplines but I am not sure of what the name is how to find a good one..........

I am pleased that you are delaying until you find a hospital that takes the appropriate precautions to ensure a more positive outcome for you.
Valerie

[Joel]

Yes, I too, think you did the right thing. Insist on both types of monitoring, and make sure the NS knows how to use it!! There have been several people on this site over the years who had bad surgery outcomes and who also had NS's who didn't use MEP monitoring...
Good decision!