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Neurovascular compression in painful tic convulsif

FONOFF, E. T.; ARAUJO, V. P.; OLIVEIRA, Y. S. A. de; TEIXEIRA, M. J.
Fonte: SPRINGER WIEN Publicador: SPRINGER WIEN
Tipo: Artigo de Revista Científica
ENG
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This article describes the case of a 67-year-old woman who presented with a typical left hemifacial spasm of 8-month duration. After 2 months, she experienced lacinating and sharp shock-like pain in the left side of her face affecting the V1 and V2 territories and a discrete attenuation of nauseous reflex on the left side. CT angiography and MRI revealed significant compression of left cranial nerves V, VII, VIII, IX and X by a giant and tortuous vertebro-basilar arterial complex. This case illustrates the nonlinearity of the relationship between the presence of the stressor factor and the actual manifestation of the disease.

Immunocalization of myosin Va in the developing nervous system of embryonic chicks

Azevedo, Alexandre; Lunardi, Laurelúcia O.; Larson, Roy E.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 395-402
ENG
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Myosins are molecular motors associated with the actin cytoskeleton that participate in the mechanisms of cellular motility. During the development of the nervous system, migration of nerve cells to specific sites, extension of growth cones, and axonal transport are dramatic manifestations of cellular motility. We demonstrate, via immunoblots, the expression of myosin Va during early stages of embryonic development in chicks, extending from the blastocyst period to the beginning of the fetal period. The expression of myosin Va in specific regions and cellular structures of the nervous system during these early stages was determined by immunocytochemistry using a polyclonal antibody. Whole mounts of chick embryos at 24-30-h stages showed intense immunoreactivity of the neural tube in formation along its full extent. Cross-sections at these stages of development showed strong labeling in neuroepithelial cells at the basal and apical regions of the neural tube wall. Embryos at more advanced periods of development (48h and 72 h) showed distinctive immunolabeling of neuroepithelial cells, neuroblasts and their cytoplasmic extensions in the mantle layer of the stratified neural tube wall, and neuroblasts and their cytoplasmic extensions in the internal wall of the optic cup...

Ultrastructure of cranial nerves of rats inoculated with rabies virus

Minguetti,Guilberto; Hofmeister,Robin M.; Hayashi,Yasuyoshi; Montaño,Juan A.
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/1997 EN
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The V and VII cranial nerves of rats inoculated with rabies virus were studied by electron microscopy. The results were compared with the same cranial nerves of rats inoculated with rabies virus but vaccinated against the disease. The findings are those of axonal degeneration and intense demyelination of the nerves of the group of rats not vaccinated. The vaccinated rats showed some ultrastructural irrelevant alterations when compared with the other group. The degree of ultrastructural alterations found in the group of rats not vaccinated suggests that in rabies severe damage of the cranial nerves occurs and that this may be closely related to the clinical picture of the disease (hydrophobia). Furthermore, as far as the authors know, this has not been considered in the classic descriptions of rabies and it is possible that an immunologic process may take part in the demyelination observed in the present study.

Bilateral carotid body paraganglioma: case report

Silva,Erasmo Simão da; Tozzi,Fábio Lambertini; Paiva,Flávia Helena Matta de; Sukys,Graziela de Almeida
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2000 EN
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CONTEXT: Surgical treatment of carotid body paragangliomas is a challenge to the surgeon because of the large vascularization of the tumor, involvement of the carotid vessels and the close anatomical relationship with the cranial nerves. CASE REPORT: A 63-year-old patient was submitted to resection of two carotid body paraganglioma tumors found in the right-side and left-side carotid bodies at the bifurcation of the common carotid arteries. Two surgeries were performed at different times and neither of them presented any morbidity. Arteriography was fundamental for diagnosis of the small, asymptomatic tumor on the right side. DESIGN: Case Report

Loss of the Sall3 Gene Leads to Palate Deficiency, Abnormalities in Cranial Nerves, and Perinatal Lethality

Parrish, M.; Ott, T.; Lance-Jones, C.; Schuetz, G.; Schwaeger-Nickolenko, A.; Monaghan, A. P.
Fonte: American Society for Microbiology Publicador: American Society for Microbiology
Tipo: Artigo de Revista Científica
Publicado em /08/2004 EN
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Members of the Spalt gene family encode putative transcription factors characterized by seven to nine C2H2 zinc finger motifs. Four genes have been identified in mice—Spalt1 to Spalt4 (Sall1 to Sall4). Spalt homologues are widely expressed in neural and mesodermal tissues during early embryogenesis. Sall3 is normally expressed in mice from embryonic day 7 (E7) in the neural ectoderm and primitive streak and subsequently in the brain, peripheral nerves, spinal cord, limb buds, palate, heart, and otic vesicles. We have generated a targeted disruption of Sall3 in mice. Homozygous mutant animals die on the first postnatal day and fail to feed. Examination of the oral structures of these animals revealed that abnormalities were present in the palate and epiglottis from E16.5. In E10.5 embryos, deficiencies in cranial nerves that normally innervate oral structures, particularly the glossopharyngeal nerve (IX), were observed. These studies indicate that Sall3 is required for the development of nerves that are derived from the hindbrain and for the formation of adjacent branchial arch derivatives.

The silent period induced by transcranial magnetic stimulation in muscles supplied by cranial nerves: normal data and changes in patients.

Werhahn, K J; Classen, J; Benecke, R
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1995 EN
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The silent period induced by transcranial magnetic stimulation of the sensorimotor cortex (Magstim 200, figure of eight coil, loop diameter 7 cm) in active muscles supplied by cranial nerves (mentalis, sternocleidomastoid, and genioglossus) was studied in 14 control subjects and nine patients with localised lesions of the sensorimotor cortex. In the patients, measurements of the silent period were also made in the first dorsal interosseus and tibialis anterior muscles. In the controls, there was a silent period in contralateral as well as ipsilateral cranial muscle and the duration of the silent period increased with increasing stimulus intensities. The mean duration of the silent period was around 140 ms in contralateral mentalis muscle and around 90 ms in contralateral sternocleidomastoid muscle at 1.2 x threshold stimulation strengths. Whereas the duration of the silent period in ipsilateral mentalis muscle was shorter than on the contralateral side it was similar on both sides in sternocleidomastoid muscle. In patients with focal lesions of the face associated primary motor cortex and corresponding central facial paresis, the silent period in mentalis muscle was shortened whereas it was unchanged or prolonged in limb muscles (first dorsal interosseus...

Virtual Cisternoscopy: 3D MRI Models of the Cerebellopontine Angle for Lesions Related to the Cranial Nerves

Rabinov, James D.; Barker, Frederick G.; McKenna, Michael J.; Curtin, Hugh D.
Fonte: Thieme Medical Publishers Publicador: Thieme Medical Publishers
Tipo: Artigo de Revista Científica
Publicado em /05/2004 EN
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This study was conducted to show that high-resolution magnetic resonance imaging (MRI) can aid in the neurosurgical approach to lesions affecting the cranial nerves (CNs) in the cerebellopontine angle (CPA). Three patients with symptomatology related to CNs VII and VIII underwent MRI examinations performed on a 1.5-Tesla Siemens MR scanner. As part of these routine examinations, the imaging technique of constructive interference in the steady state (CISS) was used to collect a volume of data through the brainstem and internal auditory canals. This high-resolution technique acquires a three-dimensional (3D) volume of data at 0.7-mm intervals. Parameters included TR 12.3/TE 5.9, number of acquisitions of 2, a matrix of 230 × 512, bandwidth of 130 Hz per pixel, and time of 8:40. Data were transferred to a commercially available GE workstation and reconstructed into a 3D surface-rendered model. This interactive method allows the model to be visualized from any angle, including that of a standard skull base approach of suboccipital craniotomy for access to the CPA cistern. The images shown include the CPA cistern as seen from the suboccipital surgical approach. CNs V, VII, and VIII can easily be seen in relation to the pons and petrous face. The relationship between the CNs and acoustic neuromas and skull base tumors can be evaluated. Vascular structures...

Imaging the cranial nerves in cancer

Chong, Vincent
Fonte: e-MED Publicador: e-MED
Tipo: Artigo de Revista Científica
Publicado em 02/04/2004 EN
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The cranial nerves are often involved in head and neck malignancies. Some malignancies have a strong propensity to show perineural spread. Cranial nerve palsy may be the presenting sign of metastatic disease to the skull base. Like metastatic disease to the lungs or liver, the cranial nerves themselves may be the site of metastatic disease. In addition, cranial nerves can be injured by radiation therapy or sacrificed during surgical treatment. This paper focuses on the imaging features of perineural infiltration, skull base neural foramen involvement and metastatic disease in the cranial nerves. It will also highlight the complications of radiation therapy, in particular radiation-induced optic neuritis.

Intraoperative Monitoring of Motor Cranial Nerves in Skull Base Surgery

Maurer, Jan; Pelster, H.; Amedee, Ronald G.; Mann, Wolf J.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /07/1995 EN
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Intraoperative monitoring of cranial nerves is performed to minimize postoperative cranial nerve dysfunction. We performed electrophysiologic monitoring of motor cranial nerves with a NIM 2 unit from Xomed Treace and a patient multiplexer developed in our clinic. This multiplexer allows simultaneous monitoring of four cranial nerves and is additionally equipped with a bipolar stimulation mode. This intraoperative monitoring was used during 102 skull base operations. Of these, 44 operations were acoustic neuroma removals by translabyrinthine approach and 36 by a middle fossa approach. Various operations, including removal of tumors of the jugular foramen and the infratemporal fossa, were performed in the remaining 22 patients. The facial nerve, being the most frequently monitored nerve, was evaluated both preoperatively and intraoperatively. Electrophysiologic data were evaluated with respect to their predictive value for postoperative facial nerve function. The relative percent decrease in amplitude of the electromyogram after resection compared to that observed before resection seems to be of some predictive value for the postoperative facial nerve function. A 50 to 60% decrease or more is associated with an increase in the House classification. Intraoperative monitoring is a useful tool in skull base surgery...

The Jugular Dural Fold—A Helpful Skull Base Landmark to the Cranial Nerves

Silverstein, Herbert; Willcox, Thomas O.; Rosenberg, Seth I.; Seidman, Michael D.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /01/1995 EN
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During a retrosigmoid (or combined retrolabyrinthine-retrosigmoid) approach to the posterior fossa for vestibular neurectomy or removal of small acoustic neuromas, a white dural fold is a consistent landmark to cranial nerves VII through XII. This fold of dura appears as a white linear structure extending from the foramen magnum across the sigmoid sinus, attaching to the posterior aspect of the temporal bone, anterior to the vestibular aqueduct. The name “jugular dural fold” is suggested for this landmark. The jugular dural fold overlies the junction of the sigmoid sinus and the jugular foramen. As measured in formalin-fixed cadaver heads, the overall length of the jugular dural fold is 20.8 mm (± 2.9 mm). The cochleovestibular nerve lies 9.9 mm (± 1.5 mm) anterior to the superior aspect of the jugular dural fold, the glossopharyngeal nerve lies 9.5 mm (± 1.6 mm) anterior to the midpoint of the jugular dural fold, and the operculum of the vestibular aqueduct lies 6.6 mm (± 0.7 mm) posterior to the jugular dural fold. Intraoperative measurements in patients undergoing combined retrolabyrinthine-retrosigmoid vestibular neurectomy show an overall length of the jugular dural fold of 16.3 mm (± 1.9 mm). The cochleovestibular nerve lies 8.6 mm (± 1.3 mm) anterior to the superior aspect of the jugular dural fold...

The Trigeminal (V) and Facial (VII) Cranial Nerves: Head and Face Sensation and Movement

Sanders, Richard D.
Fonte: Matrix Medical Communications Publicador: Matrix Medical Communications
Tipo: Artigo de Revista Científica
Publicado em /01/2010 EN
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There are close functional and anatomical relationships between cranial nerves V and VII in both their sensory and motor divisions. Sensation on the face is innervated by the trigeminal nerves (V) as are the muscles of mastication, but the muscles of facial expression are innervated mainly by the facial nerve (VII) as is the sensation of taste. This article briefly reviews the anatomy of these cranial nerves, disorders of these nerves that are of particular importance to psychiatry, and some considerations for differential diagnosis.

Cranial Nerves IX, X, XI, and XII

Gillig, Paulette Marie; Sanders, Richard D.
Fonte: Matrix Medical Communications Publicador: Matrix Medical Communications
Tipo: Artigo de Revista Científica
Publicado em /05/2010 EN
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This article concludes the series on cranial nerves, with review of the final four (IX–XII). To summarize briefly, the most important and common syndrome caused by a disorder of the glossopharyngeal nerve (craniel nerve IX) is glossopharyngeal neuralgia. Also, swallowing function occasionally is compromised in a rare but disabling form of tardive dyskinesia called tardive dystonia, because the upper motor portion of the glossopharyngel nerve projects to the basal ganglia and can be affected by lesions in the basal ganglia. Vagus nerve funtion (craniel nerve X) can be compromised in schizophrenia, bulimia, obesity, and major depression. A cervical lesion to the nerve roots of the spinal accessory nerve (craniel nerve XI) can cause a cervical dystonia, which sometimes is misdiagnosed as a dyskinesia related to neuroleptic use. Finally, unilateral hypoglossal (craniel nerve XII) nerve palsy is one of the most common mononeuropathies caused by brain metastases. Supranuclear lesions of cranial nerve XII are involved in pseudobulbar palsy and ALS, and lower motor neuron lesions of cranial nerve XII can also be present in bulbar palsy and in ALS patients who also have lower motor neuron involvement. This article reviews these and other syndromes related to cranial nerves IX through XII that might be seen by psychiatry.

Cranial nerves XIII and XIV: nerves in the shadows

Bordoni, Bruno; Zanier, Emiliano
Fonte: Dove Medical Press Publicador: Dove Medical Press
Tipo: Artigo de Revista Científica
Publicado em 13/03/2013 EN
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It has been known for over a century that these cranial nerves exist, and that they are not typographical errors nor a sensational event reported in the medical literature. A number of scientific articles on anatomy highlight how textbooks on descriptive anatomy do not always consider variables such as differences related to the geographical areas where people live, and these differences do exist. This is an important concept not only for surgeons, but also for all medical professionals who use manual techniques when treating their patients, ie, osteopaths, chiropractors, physiotherapists, and other manual therapists. This paper highlights the latest developments regarding these cranial nerves, offering at the same time some ideas for further reflection when looking at clinical scenarios that appear to bear little relationship to each other. Inclusion of these concepts in everyday anamnesis is encouraged.

Value of Free-Run Electromyographic Monitoring of Extraocular Cranial Nerves during Expanded Endonasal Surgery (EES) of the Skull Base

Thirumala, Parthasarathy D.; Mohanraj, Santhosh Kumar; Habeych, Miguel; Wichman, Kelley; Chang, Yue-fang; Gardner, Paul; Snyderman, Carl; Crammond, Donald J.; Balzer, Jeffrey
Fonte: Georg Thieme Verlag KG Publicador: Georg Thieme Verlag KG
Tipo: Artigo de Revista Científica
EN
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Objective To evaluate the value of free-run electromyography (f-EMG) monitoring of extraocular cranial nerves (EOCN) III, IV, and VI during expanded endonasal surgery (EES) of the skull base in reducing iatrogenic cranial nerve (CN) deficits.

Primary Neurolymphomatosis of the Lower Cranial Nerves Presenting as Dysphagia and Hoarseness: A Case Report

Sakai, Naoto; Ito-Yamashita, Tae; Takahashi, Goro; Baba, Satoshi; Koizumi, Shinichiro; Yamasaki, Tomohiro; Tokuyama, Tsutomu; Namba, Hiroki
Fonte: Georg Thieme Verlag KG Publicador: Georg Thieme Verlag KG
Tipo: Artigo de Revista Científica
EN
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Primary neurolymphomatosis is an extremely rare tumor. We report the case of a 74-year-old patient presenting with dysphagia and hoarseness. Initial contrast-enhanced computed tomography of the head, neck, and chest did not reveal any lesions. His symptoms improved with short-term administration of prednisone but recurred and deteriorated. Magnetic resonance (MR) imaging revealed a tumor along the ninth and tenth cranial nerves across the jugular foramen. Fluorine-18 fluorodeoxyglucose positron emission tomography indicated this was a primary tumor. Repeated MR imaging after 2 months revealed considerable tumor enlargement. A left suboccipital craniotomy was performed to remove the tumor that infiltrated the ninth and tenth cranial nerves. The histopathologic diagnosis was diffuse large B-cell lymphoma. Although focal radiation therapy was administered to ensure complete eradication of the tumor, the patient died of aspiration pneumonia with systemic metastasis. To our knowledge, this is the first reported case of primary neurolymphomatosis in the lower cranial nerves.

Hepatocellular carcinoma metastasizing to the skull base involving multiple cranial nerves

Kim, Soo Ryang; Kanda, Fumio; Kobessho, Hiroshi; Sugimoto, Koji; Matsuoka, Toshiyuki; Kudo, Masatoshi; Hayashi, Yoshitake
Fonte: Baishideng Publishing Group Co., Limited Publicador: Baishideng Publishing Group Co., Limited
Tipo: Artigo de Revista Científica
EN
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We describe a rare case of HCV-related recurrent multiple hepatocellular carcinoma (HCC) metastasizing to the skull base involving multiple cranial nerves in a 50-year-old woman. The patient presented with symptoms of ptosis, fixation of the right eyeball, and left abducens palsy, indicating disturbances of the right oculomotor and trochlear nerves and bilateral abducens nerves. Brain contrast-enhanced computed tomography (CT) revealed an ill-defined mass with abnormal enhancement around the sella turcica. Brain magnetic resonance imaging (MRI) disclosed that the mass involved the clivus, cavernous sinus, and petrous apex. On contrast-enhanced MRI with gadolinium-chelated contrast medium, the mass showed inhomogeneous intermediate enhancement. The diagnosis of metastatic HCC to the skull base was made on the basis of neurological findings and imaging studies including CT and MRI, without histological examinations. Further studies may provide insights into various methods for diagnosing HCC metastasizing to the craniospinal area.

Disorders of Cranial Nerves IX and X

Erman, Audrey B.; Kejner, Alexandra E.; Hogikyan, Norman D.; Feldman, Eva L.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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The glossopharyngeal and vagus nerves mediate the complex interplay between the many functions of the upper aerodigestive tract. Defects may occur anywhere from the brainstem to the peripheral nerve and can result in significant impairment in speech, swallowing, and breathing. Multiple etiologies can produce symptoms. This review will broadly examine the normal functions, clinical examination, and various pathologies of cranial nerves IX and X.

Neuromuscular Ultrasound of Cranial Nerves

Tawfik, Eman A.; Walker, Francis O.; Cartwright, Michael S.
Fonte: Korean Neurological Association Publicador: Korean Neurological Association
Tipo: Artigo de Revista Científica
EN
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Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

Disorders of the lower cranial nerves

Finsterer, Josef; Grisold, Wolfgang
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
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Lesions of the lower cranial nerves (LCN) are due to numerous causes, which need to be differentiated to optimize management and outcome. This review aims at summarizing and discussing diseases affecting LCN. Review of publications dealing with disorders of the LCN in humans. Affection of multiple LCN is much more frequent than the affection of a single LCN. LCN may be affected solely or together with more proximal cranial nerves, with central nervous system disease, or with nonneurological disorders. LCN lesions have to be suspected if there are typical symptoms or signs attributable to a LCN. Causes of LCN lesions can be classified as genetic, vascular, traumatic, iatrogenic, infectious, immunologic, metabolic, nutritional, degenerative, or neoplastic. Treatment of LCN lesions depends on the underlying cause. An effective treatment is available in the majority of the cases, but a prerequisite for complete recovery is the prompt and correct diagnosis. LCN lesions need to be considered in case of disturbed speech, swallowing, coughing, deglutition, sensory functions, taste, or autonomic functions, neuralgic pain, dysphagia, head, pharyngeal, or neck pain, cardiac or gastrointestinal compromise, or weakness of the trapezius, sternocleidomastoid...

Evaluation of the predictive value of intraoperative changes in motor evoked potentials of caudal cranial nerves for the postoperative functional outcome

Kullmann, Marcel
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
EN
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Objective: In this present study, we investigated the predictive value of changes in intraoperatively acquired motor evoked potentials (MEPs) of the caudal cranial nerves CN.IX (glossopharyngeal nerve) and CN.XII (hypoglossal nerve) for the operative outcome. Methods: MEPs of the glossopharyngeal (CN.IX) and hypoglossal nerve (CN.XII) were recorded intraoperatively from 63 consecutive patients undergoing brain surgery. The collected data included the patient’s age, gender, diagnosis, positioning during surgery, MEP baseline, final and final- to- baseline MEP ratio of CN.IX and CN.XII and the contralateral abductor pollicis brevis muscle of the hand as a control as well as the pre- and postoperative nerve function of CN.IX and CN.XII. We correlated the changes of the MEPs to postoperative nerve function such as dysphagia, impairment of the gag reflex, uvula deviation, and tongue deviation. Results: For the glossopharyngeal nerve, we found a significant correlation between the amplitude (µV) of the final-to-baseline MEP ratio and uvula deviation (p=0.028) and the amplitude duration (ms) of the final MEP and gag reflex function (p=0.027). The analyses of the risk estimate revealed that patients with a final-to-baseline MEP ratio of the glossopharyngeal amplitude ≤ 1.47 V have a 3.4 times increased risk to develop a uvula deviation. Patients with a final MEP of the glossopharyngeal width ≤11.6 ms have a 3.6 times increased risk for their gag reflex to become extinct. For the hypoglossal nerve...