Patients are a lot more confident when they go into surgery.
Bernhard Meyer, MD, Professor & Chair,
Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Germany.
The detailed NBS maps open the door to surgery for many patients who are currently denied surgical treatment and enable more extensive resections - while at the same time leading to better neurological outcomes.
I consider NBS mapping as a very important tool to get the best results in surgery over critical area lesions on the brain.
INDICATION FOR USE
The Nexstim Navigated Brain Stimulation System 5 (NBS System) is indicated for non-invasive mapping of the primary motor cortex of the brain to its cortical gyrus. The NBS System provides information that may be used in the assessment of the primary motor cortex for pre-procedural planning.The NBS System is not intended to be used during a surgical procedure. The NBS System is intended to be used by trained clinical professionals.
Nexstim NEXSPEECH® indicated for noninvasive localization of cortical areas that do not contain essential speech function. Nexstim NEXSPEECH® provides information that may be used in presurgical planning in patients undergoing brain surgery.
Do not use the Nexstim NBS System on:
- persons who have metallic implants anywhere in the head (excluding teeth)
- persons who have any electrical implants
- persons with increased intracranial pressure
- persons with intracardiac lines, intravenous pumps, or dose calculators.
Do not use the Nexstim NBS System without clear benefit or compelling clinical reason on:
- persons with epilepsy
- persons with serious heart disease
- persons with lowered seizure threshold due to acute large infarctions, intracranial hemorrhage, or trauma
- persons with medication that lowers the seizure threshold
- persons with cardiac pacemaker.
Women of childbearing age must be questioned about the possibility of pregnancy before participating, and excluded—if there is a chance that they may be pregnant. Women of childbearing age should not participate without clinical reason.
Risk of seizures
Cortical magnetic stimulation runs the risk of inducing seizures - although they are rare. Single-pulse TMS, which is used in mapping the cortical representation areas of specific muscles, is generally considered a non-significant risk application. However, secondarily generalized or partial motor seizures have been induced in patients with stroke, intracranial brain lesions and major disorders of the central nervous system. The seizures have occurred either during the TMS stimulation or minutes after the end of the stimulation session.