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Papers by Vizmary Montes Peña

Research paper thumbnail of T99. Assessing lower brainstem and vagal nerve integrity during posterior fossa surgery by using the laryngeal adductor reflex. Escalating intraoperative neuromonitoring of the lower brainstem

Clinical Neurophysiology, 2018

Research paper thumbnail of F115. Analyzing intraoperative neuromonitoring of visual evoked potentials parameters to optimize VEP monitoring usefulness

Clinical Neurophysiology, 2018

Research paper thumbnail of F116. Correlation of laryngeal adductor reflex, vocal CoMEPs, and vagus nerve mapping during thyroid surgery with immediate and long-term outcome: Description of two cases

Clinical Neurophysiology, 2018

Hospital. A preoperative neurophysiologic examination was performed to evaluate visual function i... more Hospital. A preoperative neurophysiologic examination was performed to evaluate visual function in all patients. LED goggles stimulation was given with stimulus duration of 15 ms, intensity of 1.5-3 cd/s.m-2 and repetition rate from 0.5 Hz to 3.0 Hz until waveforms were feasible and reproducible. Additional recording scalp electrodes (LO1: 5 cm left of O1 and LO2: 5 cm right of O2) were added to the well-known montage (Oz-Cz/Fz, O1-Cz/Fz, O2-Cz/Fz), as we wanted to assess recording reliability. Once VEP responses were obtained, pupil dilatation was induced with mydriatic agents, (prior ophthalmologic assessment) followed 20 min. later by at least two consecutive VEP recordings, to evaluate VEP N2-P2 component amplitude and latency. Although anesthetic regimen consisted in total intravenous anesthesia (TIVA) in all our cases, after surgical completion and VEP closing traces gathering, halogenated agents were added at ascending doses (from 0.1 CAM to 1.5 CAM), to value VEP waveforms stability. Written informed consent for the surgery and IONM were obtained from all patients. Results: All patients underwent pre-operative examination. In these patients, six had visual disturbances (one was severe). Ten patients were maintained under TIVA, and sevoflurane was used incidentally in one patient. Stable VEP waveforms were obtained in all patients, except in one patient with preexisting damage to the visual pathway, and another one in whom sevoflurane was used for anesthesia. The stimulus frequency showing more stable and higher waveform was below 1 Hz. There was a significant increase in VEP amplitude, but no effect on the latency after the mydriatic drug instilling. VEP traces were recordable in all channels, but in one case in where they were only obtained throughout LO1 and LO2 recording channels. The administration of halogenates agents produced a doses-dependent decrease in VEP amplitude and latency prolongation in five patients, and a complete loss of potential in three patients with doses above 1.1 CAM, all 15-20 min after application. Conclusion: Recording reliable VEPs hinge on both physiological and technical aspects. VEPs may be mitigated in patients with preoperative impaired visual function. Halogenated agents showed a major influence on IONM VEP stability. The use of cycloplegics helped in obtaining larger responses. Choosing the right stimulus frequency and including additional recording electrodes (LO1-LO2), seemed to enhance the reliability of stimulus-recordings parameters.

Research paper thumbnail of F167. Usefulness of combined surface polymyographic and back averaging techniques as essential tools in the evaluation of axial myoclonus of propriospinal origin: Two case presentation

Clinical Neurophysiology, 2018

Research paper thumbnail of P15-F Intraoperative-neuromonitoring-recording effectiveness of the laryngeal-adductor-reflex (LAR) during thyroid surgery: Immediate and long-term EMG-ENT outcome correlation

Clinical Neurophysiology, 2019

Modelado de la biodegradación en biorreactores de lodos de hidrocarburos totales del petróleo int... more Modelado de la biodegradación en biorreactores de lodos de hidrocarburos totales del petróleo intemperizados en suelos y sedimentos (Biodegradation modeling of sludge bioreactors of total petroleum hydrocarbons weathering in soil and sediments)

Research paper thumbnail of P17-T Hippocampal sclerosis (HS) with frontal lobe seizure semiology. Case presentation

Research paper thumbnail of P14-F Intraoperative-neuromonitoring (IONM) of the vagal circuit through the laryngeal-adductor-reflex (LAR) to assess the lower-brainstem’s integrity

Research paper thumbnail of P03-T A review of patients with possible Occipital-lobe-seizures (OLS) seen at University-Hospital-of-Wales (UHW) in 2018

Research paper thumbnail of T99. Assessing lower brainstem and vagal nerve integrity during posterior fossa surgery by using the laryngeal adductor reflex. Escalating intraoperative neuromonitoring of the lower brainstem

Clinical Neurophysiology, 2018

Research paper thumbnail of F115. Analyzing intraoperative neuromonitoring of visual evoked potentials parameters to optimize VEP monitoring usefulness

Clinical Neurophysiology, 2018

Research paper thumbnail of F116. Correlation of laryngeal adductor reflex, vocal CoMEPs, and vagus nerve mapping during thyroid surgery with immediate and long-term outcome: Description of two cases

Clinical Neurophysiology, 2018

Hospital. A preoperative neurophysiologic examination was performed to evaluate visual function i... more Hospital. A preoperative neurophysiologic examination was performed to evaluate visual function in all patients. LED goggles stimulation was given with stimulus duration of 15 ms, intensity of 1.5-3 cd/s.m-2 and repetition rate from 0.5 Hz to 3.0 Hz until waveforms were feasible and reproducible. Additional recording scalp electrodes (LO1: 5 cm left of O1 and LO2: 5 cm right of O2) were added to the well-known montage (Oz-Cz/Fz, O1-Cz/Fz, O2-Cz/Fz), as we wanted to assess recording reliability. Once VEP responses were obtained, pupil dilatation was induced with mydriatic agents, (prior ophthalmologic assessment) followed 20 min. later by at least two consecutive VEP recordings, to evaluate VEP N2-P2 component amplitude and latency. Although anesthetic regimen consisted in total intravenous anesthesia (TIVA) in all our cases, after surgical completion and VEP closing traces gathering, halogenated agents were added at ascending doses (from 0.1 CAM to 1.5 CAM), to value VEP waveforms stability. Written informed consent for the surgery and IONM were obtained from all patients. Results: All patients underwent pre-operative examination. In these patients, six had visual disturbances (one was severe). Ten patients were maintained under TIVA, and sevoflurane was used incidentally in one patient. Stable VEP waveforms were obtained in all patients, except in one patient with preexisting damage to the visual pathway, and another one in whom sevoflurane was used for anesthesia. The stimulus frequency showing more stable and higher waveform was below 1 Hz. There was a significant increase in VEP amplitude, but no effect on the latency after the mydriatic drug instilling. VEP traces were recordable in all channels, but in one case in where they were only obtained throughout LO1 and LO2 recording channels. The administration of halogenates agents produced a doses-dependent decrease in VEP amplitude and latency prolongation in five patients, and a complete loss of potential in three patients with doses above 1.1 CAM, all 15-20 min after application. Conclusion: Recording reliable VEPs hinge on both physiological and technical aspects. VEPs may be mitigated in patients with preoperative impaired visual function. Halogenated agents showed a major influence on IONM VEP stability. The use of cycloplegics helped in obtaining larger responses. Choosing the right stimulus frequency and including additional recording electrodes (LO1-LO2), seemed to enhance the reliability of stimulus-recordings parameters.

Research paper thumbnail of F167. Usefulness of combined surface polymyographic and back averaging techniques as essential tools in the evaluation of axial myoclonus of propriospinal origin: Two case presentation

Clinical Neurophysiology, 2018

Research paper thumbnail of P15-F Intraoperative-neuromonitoring-recording effectiveness of the laryngeal-adductor-reflex (LAR) during thyroid surgery: Immediate and long-term EMG-ENT outcome correlation

Clinical Neurophysiology, 2019

Modelado de la biodegradación en biorreactores de lodos de hidrocarburos totales del petróleo int... more Modelado de la biodegradación en biorreactores de lodos de hidrocarburos totales del petróleo intemperizados en suelos y sedimentos (Biodegradation modeling of sludge bioreactors of total petroleum hydrocarbons weathering in soil and sediments)

Research paper thumbnail of P17-T Hippocampal sclerosis (HS) with frontal lobe seizure semiology. Case presentation

Research paper thumbnail of P14-F Intraoperative-neuromonitoring (IONM) of the vagal circuit through the laryngeal-adductor-reflex (LAR) to assess the lower-brainstem’s integrity

Research paper thumbnail of P03-T A review of patients with possible Occipital-lobe-seizures (OLS) seen at University-Hospital-of-Wales (UHW) in 2018