[go: up one dir, main page]

WO2023003229A1 - Appareil de surveillance neurologique et son procédé de commande - Google Patents

Appareil de surveillance neurologique et son procédé de commande Download PDF

Info

Publication number
WO2023003229A1
WO2023003229A1 PCT/KR2022/009784 KR2022009784W WO2023003229A1 WO 2023003229 A1 WO2023003229 A1 WO 2023003229A1 KR 2022009784 W KR2022009784 W KR 2022009784W WO 2023003229 A1 WO2023003229 A1 WO 2023003229A1
Authority
WO
WIPO (PCT)
Prior art keywords
monitoring
evoked potential
patient
abnormality
information
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/KR2022/009784
Other languages
English (en)
Korean (ko)
Inventor
양승호
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Industry Academic Cooperation Foundation of Catholic University of Korea
Original Assignee
Industry Academic Cooperation Foundation of Catholic University of Korea
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Industry Academic Cooperation Foundation of Catholic University of Korea filed Critical Industry Academic Cooperation Foundation of Catholic University of Korea
Publication of WO2023003229A1 publication Critical patent/WO2023003229A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/103—Measuring devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor or mobility of a limb
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/294—Bioelectric electrodes therefor specially adapted for particular uses for nerve conduction study [NCS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/30—Input circuits therefor
    • A61B5/307—Input circuits therefor specially adapted for particular uses
    • A61B5/311—Input circuits therefor specially adapted for particular uses for nerve conduction study [NCS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/369—Electroencephalography [EEG]
    • A61B5/377—Electroencephalography [EEG] using evoked responses
    • A61B5/383—Somatosensory stimuli, e.g. electric stimulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/388—Nerve conduction study, e.g. detecting action potential of peripheral nerves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/389—Electromyography [EMG]
    • A61B5/395—Details of stimulation, e.g. nerve stimulation to elicit EMG response
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4041—Evaluating nerves condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4842—Monitoring progression or stage of a disease
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7225—Details of analogue processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation

Definitions

  • the present invention relates to a nerve monitoring device and a control method thereof, and more particularly, to a nerve monitoring device capable of continuously monitoring a patient's nerves in an awake state and a control method thereof.
  • a neural monitoring device is a system that provides real-time information on a patient's neurophysiological changes during nerve-related surgery, and is essential equipment for spinal disease, cerebrovascular disease, and brain tumor surgery.
  • This neural monitoring device monitors 12 cranial nerves and performs various functions such as motor evoked potentials (MEP), somatosensory evoked potentials (SSEP), auditory evoked potentials (AEP), electromyography (EMG), electrocorticography (ECOG), and electroencephalogram (EEG).
  • MEP motor evoked potentials
  • SSEP somatosensory evoked potentials
  • AEP auditory evoked potentials
  • EMG electromyography
  • ECG electrocorticography
  • EEG electroencephalogram
  • EEG electroencephalogram
  • the present invention has been proposed to solve the above problems, and analyzes clinical information on nerve monitoring during surgery to determine the relationship between diseases, lesion locations, and neurological conditions, and the possible scale and range at the time of awakening.
  • the object of the present invention is to provide a neural monitoring device and a method for controlling the same that can continuously monitor the patient's nerves in an awakened state.
  • a neural monitoring apparatus for solving the above problems includes a communication module for transmitting and receiving at least one information or data with at least one manager terminal; a stimulation application module for applying a preset stimulation signal to each electrode attached to at least one part of the patient; a detection module for detecting and amplifying at least one of a motor evoked potential and a somatosensory evoked potential generated by the stimulation signal applied to each of the electrodes; a processing module that converts at least one of the amplified motor evoked potential and the amplified somatosensory evoked potential into a digital signal and removes a noise signal to generate each monitoring signal; a generation module for generating a monitoring period for each part by checking whether the patient has an abnormality based on the generated monitoring signal; a storage module for storing various data or information and at least one process necessary for monitoring the patient's nerves; and a control module that performs an operation for monitoring the patient's nerves based on the at least one process, wherein the control module is
  • a preset stimulation signal is applied to each electrode attached to at least one part of a patient. doing; detecting and amplifying the motor evoked potential and the somatosensory evoked potential generated by the stimulation signal applied to each of the electrodes; converting the amplified motor evoked potential and the amplified somatosensory evoked potential into digital signals and removing noise signals to generate monitoring signals; and generating a monitoring cycle for each part by checking whether the patient has an abnormality based on the generated monitoring signal.
  • the present invention it is possible to present possible scales and ranges at the time of awakening by analyzing clinical information on nerve monitoring during surgery to identify the relationship between diseases, lesion locations, and neurological conditions, and through this, the awakened state allows continuous neurological monitoring of the patient.
  • FIG. 1 is a diagram showing the network structure of a neural monitoring system according to an embodiment of the present invention.
  • FIG. 2 is a diagram showing the configuration of a neural monitoring device according to an embodiment of the present invention.
  • FIG. 3 is a flowchart illustrating a control method for performing a neural monitoring apparatus according to an embodiment of the present invention.
  • FIG. 4 is a diagram illustrating an example of examination information displayed through a display unit of a neural monitoring apparatus in a neural monitoring system according to an embodiment of the present invention.
  • 5A to 5C are diagrams illustrating an example of monitoring information displayed through a display unit of an administrator terminal in a neural monitoring system according to an embodiment of the present invention.
  • spatially relative terms “below”, “beneath”, “lower”, “above”, “upper”, etc. It can be used to easily describe a component's correlation with other components. Spatially relative terms should be understood as including different orientations of elements in use or operation in addition to the orientations shown in the drawings. For example, if you flip a component that is shown in a drawing, a component described as “below” or “beneath” another component will be placed “above” the other component. can Thus, the exemplary term “below” may include directions of both below and above. Components may also be oriented in other orientations, and thus spatially relative terms may be interpreted according to orientation.
  • unit or “module” used in the specification means a hardware component such as software, FPGA or ASIC, and "unit” or “module” performs certain roles. However, “unit” or “module” is not meant to be limited to software or hardware. A “unit” or “module” may be configured to reside in an addressable storage medium and may be configured to reproduce one or more processors. Thus, as an example, a “unit” or “module” may refer to components such as software components, object-oriented software components, class components, and task components, processes, functions, properties, procedures, subroutines, segments of program code, drivers, firmware, microcode, circuitry, data, databases, data structures, tables, arrays and variables. Functions provided within components and “units” or “modules” may be combined into fewer components and “units” or “modules” or may be combined into additional components and “units” or “modules”. can be further separated.
  • Intraoperative neurophysiological monitoring is a method of performing neurophysiological tests to prevent damage to the nervous system during surgery.
  • MEP motor evoked potential
  • SSEP somatosensory evoked potential
  • the motor evoked potential test stimulates the brain movement pathway through stimulation electrodes installed on the scalp, and the muscle response through recording electrodes installed on both arms (thumb and abductors of the little finger) and both legs (tibialis anterior and abductors of the big toe)
  • the motor evoked potential indicates the activity level of the overall motor nervous system connected to the cerebral cortex and cerebrospinal fluid.
  • the stimulation to the cerebrospinal fluid is a potential generated by contracting distal muscles in the corresponding spinal cord through the alpha motor nerve. Therefore, the motor evoked potential is related to the excitability of the cerebral cortex, and the failure to induce the motor evoked potential during appropriate magnetic stimulation means that the nerve cell or nerve stem is dead or has a very high motor threshold.
  • the somatosensory evoked potential test is a test that stimulates the median nerve at the wrist and the posterior tibial nerve at the ankle and records the response of the sensory area in a waveform form through a recording electrode installed on the scalp. It is one of the most used methods. Although it evaluates the sensory nervous system, it is often used to detect changes in the motor nervous system, not just the sensory nervous system, as the location of the motor nervous system and the sensory nervous system are often close. SSEP is widely used because it can be measured more frequently than MEP, waveforms can be obtained stably, and it is helpful in evaluating the location of lesions.
  • the present invention is basically for the examination of the cortical area responsible for the motor system of the brain through motor evoked potentials, but since it is difficult to perform such an examination after surgery, it is difficult to perform the sensory cortex examination through somatosensory evoked testing, thereby indirectly inducing the motor system. It is intended to perform a test of the cortex responsible for As described above, this is to use the feature that the position of the motor nervous system and the sensory nervous system are close.
  • the present invention performs a motor evoked potential test and a somatosensory evoked potentials test during surgery, and sets a monitoring cycle based on the results of the operation, so that the patient carry out surveillance on Furthermore, the monitoring information is transmitted to at least one manager so that a quick response to abnormal symptoms is possible.
  • the manager may be a medical staff, guardian, device manager, etc., but is not limited thereto.
  • FIG. 1 is a diagram showing the network structure of a neural monitoring system according to an embodiment of the present invention.
  • a neural monitoring system 10 may include a neural monitoring device 100 , an electrode module 200 and at least one manager terminal 300 .
  • the nerve monitoring device 100 periodically or continuously monitors motor evoked potential tests and somatosensory evoked potentials through at least one electrode attached to the patient's body during surgery to check whether the patient is abnormal, and Set the monitoring cycle for each part according to the confirmation result. Thereafter, the nerve monitoring device 100 periodically or continuously monitors the somatosensory evoked potential through at least one electrode attached to the patient's body after surgery to check whether the patient has an abnormality, and monitors based on the confirmation result.
  • Information is generated and transmitted to at least one manager terminal 300 . At this time, at least one manager terminal 300 transmitting monitoring information may be a terminal registered in advance.
  • both the motor evoked potential and the somatosensory evoked potential from the patient are monitored to set the monitoring cycle to be applied after surgery. Since it is difficult to monitor the motor evoked potential from the patient after surgery, Based on this, only somatosensory evoked potentials are monitored.
  • the electrode module 200 may include at least one electrode unit attached to at least one part of the patient. At this time, the electrode module 200 may include a first electrode unit 201 attached to the motor nervous system and a second electrode unit 202 attached to the sensory nervous system.
  • FIG. 1 shows the first electrode unit 201 attached to the motor nervous system and the second electrode unit 202 attached to the sensory nervous system, this is for convenience of description, and the motor nervous system and/or the sensory nervous system A plurality of first electrode units and/or second electrode units may be provided to monitor evoked potentials of various corresponding parts.
  • Electrode positions for TES are represented by the 10-10 system, which is a slightly modified version of the international 10-20 system for electroencephalography.
  • C3/C4 C3 and C4
  • both the evoked potentials of the arm and leg on the opposite side of the polarity are recorded.
  • C3/C4 stimulation is delivered to a location where the movement is large and deep.
  • Using C1/C2 is similar to C3/C4, but the degree of movement is weak and the stimulation depth is shallow.
  • Somatosensory evoked potentials can be recorded using surface electrodes or needle electrodes, and are performed by stimulating the median nerve in the upper limbs and the tibial nerve in the lower limbs.
  • the ulnar nerve is stimulated when monitoring of the lower cervical region, such as C8-T1 in the upper limb, is required. If it is difficult to stimulate the tibial nerve in the lower limb, the peroneal nerve or the tibial nerve in the popliteal fossa can be stimulated.
  • the electric stimulation gives a square-shaped stimulation through which a constant current of 0.2-0.3 ms flows, and the maximum stimulation intensity is about three times the stimulation threshold for sensory nerves or twice the stimulation threshold for motor nerves.
  • the stimulation frequency avoids the factor of 60 Hz. Commonly recommended stimulation frequencies are 4.7 and 5.1 Hz.
  • At least one manager terminal 300 may be a terminal used by a manager, and displays monitoring information received from the nerve monitoring apparatus 100 so that the manager checks the patient's condition.
  • Mobile terminals mobile phones, smart phones, laptop computers, desktop computers, digital broadcasting terminals, PDA (personal digital assistants), PMP (portable multimedia player), navigation, slate PC ( slate PC), tablet PC (tablet PC), ultrabook (ultrabook), wearable device (for example, watch type terminal (smartwatch), glass type terminal (smart glass), HMD (head mounted display), etc.) It may be a computer device or a telecommunications device, but is not limited thereto.
  • FIG. 2 is a diagram showing the configuration of a neural monitoring device according to an embodiment of the present invention.
  • the monitoring device 100 includes a communication module 110, a stimulus application module 120, a detection module 130, a processing module 140, a generation module 150, a storage module 160, and a control It consists of a module 170.
  • the communication module 110 transmits and receives at least one piece of information or data with at least one manager terminal 300 .
  • the communication module 110 may perform communication with other servers or devices, and transmit and receive wireless signals in a communication network according to wireless Internet technologies.
  • Wireless Internet technologies include, for example, WLAN (Wireless LAN), Wi-Fi (Wireless-Fidelity), Wi-Fi (Wireless Fidelity) Direct, DLNA (Digital Living Network Alliance), WiBro (Wireless Broadband), WiMAX (World Interoperability for Microwave Access), HSDPA (High Speed Downlink Packet Access), HSUPA (High Speed Uplink Packet Access), LTE (Long Term Evolution), LTE-A (Long Term Evolution-Advanced), etc., and the condition setting device (100 ) transmits and receives data according to at least one wireless Internet technology within a range including Internet technologies not listed above.
  • BluetoothTM RFID (Radio Frequency Identification), Infrared Data Association (IrDA), UWB (Ultra Wideband), ZigBee, NFC (Near Field Communication), Wi -Local communication may be supported using at least one of wireless-fidelity (Fi), Wi-Fi Direct, and wireless universal serial bus (USB) technologies.
  • Wireless communication between the neural monitoring device 100 and at least one manager terminal 300 may be supported through such wireless area networks.
  • the local area wireless communication network may be a local area wireless personal area network (Wireless Personal Area Networks).
  • the stimulation application module 120 applies a preset stimulation signal to each electrode attached to at least one part of the patient.
  • the stimulation signal may be applied by generating and transmitting an electrical current.
  • the stimulation application module 120 may apply different stimulation signals to the first stimulation unit 201 attached to the motor nervous system and the second stimulation unit 202 attached to the sensory nervous system.
  • this is only one embodiment, and may be configured to further generate other stimulation signals for monitoring other nervous systems other than the motor nervous system or the sensory nervous system, but is not limited thereto.
  • the detection module 130 detects and amplifies an evoked potential generated by a stimulation signal applied to each electrode.
  • the detection module 130 detects and amplifies the motor evoked potential from the first stimulation unit 201 and detects and amplifies the somatosensory evoked potential from the second stimulation unit 202 .
  • the processing module 140 converts the amplified motor evoked potential and/or the amplified somatosensory evoked potential into digital signals and removes noise signals to generate monitoring signals.
  • the monitoring signal is a coupling variable used in the neural monitoring device 100 to know the state of the patient's nervous system during or after surgery. ) is created using the value.
  • the processing module 140 extracts the latencies of the peaks of the evoked potentials generated after the stimulus is applied and the amplitudes of the peaks from the evoked potential, and calculates the amplitude of the peaks at the time of occurrence.
  • the ratio is generated as a monitoring signal.
  • the generation module 150 compares each monitoring signal with a preset reference signal to check whether there is an abnormality, and generates (sets) a monitoring cycle for each part based on the checking result.
  • the patient has an abnormality can be confirmed by comparing the waveform of each monitoring signal with a reference waveform (basic waveform) corresponding thereto.
  • the reference waveform may be preset (stored) for each part.
  • the storage module 160 stores various data (information) received by the nerve monitoring device 100 or generated or acquired (measured) by the nerve sensing device 100, and at least one required for monitoring the patient's nerves. save the process
  • the control module 170 controls all components to perform an operation for monitoring the patient's nerves based on at least one process stored in the storage module 160 .
  • the control module 170 applies preset stimulation signals to each of the first electrode unit 201 attached to the motor nervous system and the second electrode unit 202 attached to the sensory nervous system of the patient under surgery, and applies the After detecting and amplifying the motor evoked potential and the somatosensory evoked potential generated from each of the first electrode part 201 and the second electrode part 202 by the stimulated signal, the amplified evoked potential is converted into a digital signal and noise Each monitoring signal is generated by removing the signal, and each monitoring signal is compared with a preset reference signal to check whether or not there is an abnormality, thereby controlling to set (save) the monitoring cycle for each part.
  • the control module 170 applies a preset stimulus signal to the second electrode unit 202 based on the previously set monitoring cycle from the patient after surgery, and After detecting and amplifying the somatosensory evoked potential generated from the second electrode unit 202 by the stimulation signal, the amplified somatosensory evoked potential is converted into a digital signal and the noise signal is removed to generate a monitoring signal. At this time, the control module 170 only tests somatosensory evoked potentials because it is impossible to test motor evoked potentials from patients after surgery.
  • control module 170 checks whether there is an abnormality in the monitoring signal, and if there is an abnormality as a result of the checking, monitoring information is generated and transmitted to at least one manager terminal 300 registered in advance.
  • control module 170 attaches electrodes to the patient undergoing surgery to examine the motor evoked potential and somatosensory evoked potential for each part, and determines the monitoring period to be applied after surgery based on whether or not there is an abnormality according to the test result. After setting and saving for each part, if it is set to monitoring mode, it is controlled to inspect the somatosensory evoked potential for each part based on the previously set monitoring period.
  • the neural monitoring apparatus 100 may be configured to set an inspection mode or a monitoring mode, and each mode may be set according to an input signal from a manager.
  • the control module 170 checks the motion evoked potential and the somatosensory evoked potential for each part through an electrode attached to at least one part of the patient and checks whether there is an abnormality.
  • the monitoring cycle is set for each part, and when the monitoring mode is set, the somatosensory evoked potential for each part is checked through an electrode attached to at least one part of the patient to check for abnormalities, and this is registered in advance through monitoring information. It may be determined whether to inform at least one manager terminal 300 .
  • the neural monitoring apparatus 100 may further include an input module, an imaging module, and a display module. Through this display module, video or images acquired through the imaging module as well as monitoring signals are displayed so that the administrator can visually check data, and information (data) or various signals can be input through the input module.
  • the neural monitoring apparatus 100 may be configured to include more or fewer components in addition to the components shown in FIG. 2 .
  • FIG. 3 is a flowchart illustrating a control method for performing a neural monitoring apparatus according to an embodiment of the present invention.
  • the nerve monitoring device 100 applies preset stimulation signals to each of the first electrode unit 201 attached to the motor nervous system and the second electrode unit 202 attached to the sensory nervous system of the patient during surgery (S301), and The motor evoked potential and the somatosensory evoked potential generated from each of the first electrode unit 201 and the second electrode unit 202 are detected and amplified by the applied stimulation signal (S303).
  • the neural monitoring device 100 converts the two evoked potentials amplified in step S303 into digital signals and removes the noise signal to generate each monitoring signal (S305), and converts each monitoring signal to a preset reference signal. By comparing, an abnormality is checked and a monitoring period for application after surgery is set (S307).
  • the monitoring period can be set as shown in Table 1 below.
  • the monitoring period is divided into cases in which there is an abnormality in both the motor evoked potential and the somatosensory evoked potential, in the case where there is an abnormality in the motor evoked potential or somatosensory evoked potential, and in the case where there is no abnormality in both the motor evoked potential and the somatosensory evoked potential. It can be set differently for each part.
  • This monitoring period can be set in the order of T1 ⁇ T2 ⁇ T3 ⁇ T4 or T1 ⁇ T3 ⁇ T2 ⁇ T4 because more intensive management is required for the area with abnormalities. That is, when an abnormality is confirmed, the monitoring cycle is set shorter to monitor more intensively.
  • the nerve monitoring device 100 transmits a preset stimulation signal to the second electrode unit 202 based on the monitoring period set in step S307 from the patient after surgery. is applied (S309), and the somatosensory evoked potential generated from the second electrode unit 202 is detected and amplified by the applied stimulation signal (S311).
  • the neural monitoring apparatus 100 converts the somatosensory evoked potential amplified in step S311 into a digital signal and removes the noise signal to generate a monitoring signal (S313), and the waveform of the generated monitoring signal and a reference waveform (basic Waveforms) to determine whether or not the patient has an abnormality (315).
  • step S315 monitoring information is generated based on the monitoring signal generated in step S313 and transmitted to at least one manager terminal 300 registered in advance.
  • step 317 is performed only when it is determined that the patient has an abnormality, and may be omitted when it is determined that there is no abnormality.
  • step 317 is performed only when it is determined that the patient has an abnormality, and may be omitted when it is determined that there is no abnormality.
  • the monitoring information may include at least one of patient personal information, information on abnormal symptoms, and monitoring signal information, and may be visualized and displayed through a display unit of at least one manager terminal 300 registered in advance.
  • patient groups eg, ultra-high-risk group, high-risk group, etc.
  • the neural monitoring apparatus 100 may change the set period based on the change information when change information for changing the set period is obtained from at least one manager terminal 300 . For example, if the manager determines through monitoring information that there is a serious abnormal reaction to the somatosensory evoked potential measured in a specific area, the monitoring cycle is changed to a shorter period than the previously set period for more intensive monitoring of that specific area. that can be done
  • the recorded opinion or action can be shared with other administrators.
  • FIG. 4 is a diagram illustrating an example of examination information displayed through a display unit of a neural monitoring apparatus according to an embodiment of the present invention.
  • the nerve monitoring device 100 may include a display unit or may be provided by connecting a separate display device, and the examination information or monitoring information generated by the nerve monitoring device 100 through the display unit (display device). can be displayed.
  • test results that is, monitoring signals for each of the motor evoked potential and the somatosensory evoked potential and their measured values can be displayed as test information.
  • various data related to the patient's current condition blood pressure, heart rate, respiration, oxygen saturation, etc.
  • an image (video) of the surgical site may be displayed on the display unit 180 together.
  • 5A to 5C are diagrams illustrating an example of monitoring information displayed through a display unit of an administrator terminal in a neural monitoring system according to an embodiment of the present invention.
  • the manager terminal 300 visualizes and displays the monitoring information received from the neural monitoring apparatus 100 on the display unit 310 .
  • the patient's personal information and surgery information are displayed, and the manager can confirm the abnormal reaction through the waveform of the monitoring signal in which the abnormality is detected.
  • the administrator who has confirmed the monitoring information can check the monitoring cycle of the patient, input and record his/her opinion on the abnormal reaction as well as actions taken accordingly. configure the user interface so that
  • the manager terminal 300 may provide monitoring information by including data related to evoked potentials for a plurality of patients in the form of a list, through which the manager can provide monitoring information on evoked potentials during surgery for a plurality of patients. It is possible to check the cause of the abnormality of the condition as well as the progress after surgery according to the measures (management).
  • FIG. 5C shows that the list includes only data on kinetic evoked potentials, this is only one example and can be configured to further include other data as well as data on somatosensory evoked potentials. may be
  • 5A to 5C may be displayed on one screen, and may be configured to partially check through scrolling.
  • Steps of a method or algorithm described in connection with an embodiment of the present invention may be implemented directly in hardware, implemented in a software module executed by hardware, or implemented by a combination thereof.
  • a software module may include random access memory (RAM), read only memory (ROM), erasable programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), flash memory, hard disk, removable disk, CD-ROM, or It may reside in any form of computer readable recording medium well known in the art to which the present invention pertains.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Biophysics (AREA)
  • Pathology (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Neurology (AREA)
  • Physiology (AREA)
  • Signal Processing (AREA)
  • Neurosurgery (AREA)
  • Psychiatry (AREA)
  • Artificial Intelligence (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Power Engineering (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Psychology (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Computer Networks & Wireless Communication (AREA)
  • Medicinal Chemistry (AREA)
  • Anesthesiology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Chemical & Material Sciences (AREA)

Abstract

La présente invention concerne un appareil de surveillance neurologique, et son procédé de commande, l'appareil de surveillance neurologique présentant des échelles et des plages possibles post-anesthésie en analysant des données cliniques de surveillance neurologique d'une chirurgie, et en identifiant la pertinence vis-à-vis de chaque maladie, localisation de lésion, et état neurologique, et en conséquence, la présente invention peut effectuer de manière continue une surveillance neurologique d'un patient sous un état éveillé.
PCT/KR2022/009784 2021-07-19 2022-07-06 Appareil de surveillance neurologique et son procédé de commande Ceased WO2023003229A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2021-0093958 2021-07-19
KR1020210093958A KR102558032B1 (ko) 2021-07-19 2021-07-19 신경 감시 장치 및 그 제어 방법

Publications (1)

Publication Number Publication Date
WO2023003229A1 true WO2023003229A1 (fr) 2023-01-26

Family

ID=84980253

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2022/009784 Ceased WO2023003229A1 (fr) 2021-07-19 2022-07-06 Appareil de surveillance neurologique et son procédé de commande

Country Status (2)

Country Link
KR (3) KR102558032B1 (fr)
WO (1) WO2023003229A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117982184A (zh) * 2024-04-02 2024-05-07 华中科技大学 一种用于脑牵开器手术的颅脑状态监测系统及制备方法
CN119034106A (zh) * 2024-10-30 2024-11-29 中国康复研究中心 一种基于骶神经电活动侦听的闭环电调控系统

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102641399B1 (ko) 2023-03-20 2024-02-28 충북대학교병원 클라우드 기반의 수술 중 신경생리학적 모니터링 서비스를 지원하는 시스템

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2012505707A (ja) * 2008-10-15 2012-03-08 ニューヴェイジヴ，インコーポレイテッド 神経生理学的監視システムおよび関連方法
KR101270935B1 (ko) * 2012-01-19 2013-06-11 서울대학교산학협력단 수술 중 신경계 감시 장치 및 방법
KR101607893B1 (ko) * 2014-12-15 2016-04-11 고려대학교 산학협력단 정상 상태 체감각 유발 전위 발생 장치 및 그 운용 방법
JP2017502711A (ja) * 2013-11-07 2017-01-26 セーフオプ サージカル インコーポレイテッド 神経機能を検出するためのシステムおよび方法
US20170303811A1 (en) * 2005-02-02 2017-10-26 Nuvasive, Inc. System and Methods for Performing Neurophysiologic Assessments During Spine Surgery

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR101935666B1 (ko) 2017-05-15 2019-01-04 서울대학교산학협력단 착탈식 침전극 및 이를 포함하는 다채널 무선 수술중 신경계 감시 시스템

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20170303811A1 (en) * 2005-02-02 2017-10-26 Nuvasive, Inc. System and Methods for Performing Neurophysiologic Assessments During Spine Surgery
JP2012505707A (ja) * 2008-10-15 2012-03-08 ニューヴェイジヴ，インコーポレイテッド 神経生理学的監視システムおよび関連方法
KR101270935B1 (ko) * 2012-01-19 2013-06-11 서울대학교산학협력단 수술 중 신경계 감시 장치 및 방법
JP2017502711A (ja) * 2013-11-07 2017-01-26 セーフオプ サージカル インコーポレイテッド 神経機能を検出するためのシステムおよび方法
KR101607893B1 (ko) * 2014-12-15 2016-04-11 고려대학교 산학협력단 정상 상태 체감각 유발 전위 발생 장치 및 그 운용 방법

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN117982184A (zh) * 2024-04-02 2024-05-07 华中科技大学 一种用于脑牵开器手术的颅脑状态监测系统及制备方法
CN117982184B (zh) * 2024-04-02 2024-07-09 华中科技大学 一种用于脑牵开器手术的颅脑状态监测系统及制备方法
CN119034106A (zh) * 2024-10-30 2024-11-29 中国康复研究中心 一种基于骶神经电活动侦听的闭环电调控系统

Also Published As

Publication number Publication date
KR20230013330A (ko) 2023-01-26
KR20240049252A (ko) 2024-04-16
KR102558032B1 (ko) 2023-07-19
KR102655437B1 (ko) 2024-04-04
KR20230113246A (ko) 2023-07-28

Similar Documents

Publication Publication Date Title
US20240341664A1 (en) Systems and methods for detecting nerve function
EP2440125B1 (fr) Appareil pour détection automatique d'effet de positionnement
WO2023003229A1 (fr) Appareil de surveillance neurologique et son procédé de commande
Kamousi et al. Comparing the quality of signals recorded with a rapid response EEG and conventional clinical EEG systems
US20070282217A1 (en) Methods & systems for intraoperatively monitoring nerve & muscle frequency latency and amplitude
US20090048531A1 (en) Dermatomal somatosensory evoked potential (dssep) apparatus for real time nerve root function diagnosis in surgical and clinical situations
JP2004517669A (ja) 鎮静状態・麻痺状態・神経結合性をモニタリングする方法およびシステム
EP2512332A1 (fr) Méthode et dispositif pour l'évaluation neurologique d'intervention et le guidage du traitement
JP2020179290A (ja) システム
Zhou et al. Wireless facial biosensing system for monitoring facial palsy with flexible microneedle electrode arrays
US7549959B2 (en) Stimulation arrangement for measurement of physiological signal reactivity
WO2012115346A2 (fr) Dispositif et procédé de surveillance de nerfs faciaux
Farajidavar et al. Electromagnetic interference in intraoperative monitoring of motor evoked potentials and a wireless solution
Cifrek et al. Inspection and testing of electroencephalographs, electromyographs, and evoked response equipment
Foreman et al. Amplitude-integrated electroencephalography: a new approach to enhancing neurologic nursing care in the neonatal intensive care unit
Molanes et al. Design of a muscle activity monitor for rehabilitation of post-stroke patients
Hotur et al. Bluetooth Enabled Microcontroller-based Stimulator for Assessing the Electrical Activity of Muscles
Cifrek et al. Electromyographs, and Evoked Response
Cao et al. An EEG diagnosis system for quasi brain death based on complexity and energy analyses
US20080281378A1 (en) Neurological diagnostic and therapeutic system utilizing function-specific modules
de Almeida Bioglasses: Biosignal-based Biometrics using Sensors
Guerrero et al. Investigating Electromagnetic Interference in Intraoperative Monitoring and a Telemetric Solution
HK1237236B (zh) 具有更高保真度的评估神经肌肉接头状态的设备和方法

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 22846101

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 22846101

Country of ref document: EP

Kind code of ref document: A1