Clinical significance of monitoring the central nervous system in the operation room and the intensive care unit

Electrophysiological monitoring of the central nervous system (CNS) has become a valuable adjunct, and in selected circumstances, a standard of care for surgical procedures where there is a possibility of neuronal injury. Electrophysiological monitoring is made possible by the inborn electrical properties of the human nervous system, thus assessing both structural and functional aspects of the neural pathways tested. These methods can be used when the patient is unable to cooperate (e.g. traumatic coma) or is rendered unconscious (e.g. anaesthesia, intensive care unit, ICU). Although limited to specific neural pathways of the central and the peripheral nervous system, these techniques have become an essential component of some surgical procedures, where their use provides amatchless contribution to intraoperative decision making.