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More than 3 million individuals in the United States have epilepsy, and over 50 million worldwide. One million in the United States continue to suffer from seizures, despite medication. Their mortality is twice that of the general population, i.e., about 2% mortality per year.1,2 Surgery for epilepsy has a favorable outcome. Among well-selected patients, 70% are seizure-free after surgery. Many of the remaining patients have seizure frequency greatly reduced, e.g., from twice weekly to twice yearly. Surgical outcome avoids mortality risk, morbidity, and costs of medically refractory seizures, and greatly enhances the patient’s quality of life. Yet only 2000 patients per year undergo resective surgery. Surgery for epilepsy is very underutilized.3
Intraoperative neurophysiologic monitoring has shown a steady increase in use for surgeries in which neural structures may be at risk of injury. Some of the surgical techniques used carry inherent risks, and these risks have changed the way in which neurophysiologic monitoring has impacted patient safety and quality of care during surgical procedures. It is therefore crucial that those performing and interpreting intraoperative neurophysiologic monitoring are adequately trained. This book is a comprehensive guide to the current practice of intraoperative neurophysiology with chapters on various modalities and clinical uses. Separate chapters devoted to anesthesia, operating room environment, special considerations in pediatrics and the interpretation and reporting of neurophysiologic data are useful and complementary. Questions and detailed answers on the topics covered can be found on the accompanying website for study review. This book will be useful to the trainee as well as the neurophysiologist already in practice.