Intraoperative localization of the central sulcus by cortical somatosensory evoked potentials in brain tumor. Case report.

Abstract

Perplexing findings of cortical somatosensory evoked potentials (SEP's) for determining the central sulcus during a craniotomy are reported in a case of brain tumor. On stimulation of the contralateral median nerve in that patient, phase-reversal of SEP waves N1 and P2 was observed not only across the central sulcus but also across the precentral sulcus. In topographic mapping of the N1-P2 amplitude, the sulcus dividing the maximum polarity was the central sulcus; this was confirmed by the cortical stimulation-evoked motor responses. For accurate localization of the central sulcus by cortical SEP's, the distribution of potentials must be analyzed with extensive exposure of the sensorimotor cortex.