{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:58:36Z","timestamp":1773158316628,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intraoperative neurophysiological mapping can help identify the trigeminal nerve (TN) during surgeries where it is at risk. Low-stimulating currents may only recruit sensory branch stimulation and trigger reflex responses, potentially complicating interpretation during monitoring. This report aims to address this issue by examining cases to categorize TN responses in relation to varying stimulation intensities, identify stimulation patterns, and clarify common response characteristics in surgical contexts.<\/jats:p>\n                  <jats:p>Seven cerebellopontine (CP) angle surgery cases with TN exposure were studied. Concentric bipolar stimulation was applied over the TN from 0.05 to 4\u2009mA, and responses were recorded from various muscles innervated by the cranial nerves under monitoring (V, VII, IX, X, XI, XII).<\/jats:p>\n                  <jats:p>Low stimulation currents (particularly below 0.5\u2009mA) may elicit reflex responses over hypoglossal and facial innervated muscles, more often than motor responses, when the TN is stimulated.<\/jats:p>\n                  <jats:p>A stimulation protocol starting at 0.05\u2009mA and increasing to at least 1\u2009mA or until compound muscle action potentials are observed in trigeminally innervated muscles is recommended for accurate TN mapping in CP angle surgery. These results may be helpful to avoid misinterpreting reflex responses in non-TN-innervated muscles<\/jats:p>","DOI":"10.1055\/a-2561-7866","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T20:00:41Z","timestamp":1744142441000},"page":"137-143","source":"Crossref","is-referenced-by-count":0,"title":["Pitfalls in Trigeminal Nerve Mapping in Neurosurgery: The Mystery of the Unexpected Motor Responses"],"prefix":"10.1055","volume":"87","author":[{"given":"Jose David Siado","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Queen's Hospital, Barking Havering and Redbridge NHS Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5272-898X","authenticated-orcid":false,"given":"Ana Mirallave","family":"Pescador","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology King's College Hospital NHS Foundation Trust, London, United Kingdom"},{"name":"Department of Neurosurgery King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba Diaz","family":"Baamonde","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology King's College Hospital NHS Foundation Trust, London, United Kingdom"},{"name":"Department of Neurosurgery King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Shapey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sian Ebony","family":"Murace","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily Clare","family":"Lawson","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjel","family":"Lejarde","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinan","family":"Barazi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery King's College Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/ca.22330","article-title":"Microsurgical anatomy of the trigeminal nerve","volume":"27","author":"W Joo","year":"2014","journal-title":"Clin Anat"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1093\/brain\/awz407","article-title":"Topography of the pain in classical trigeminal neuralgia: insights into somatotopic organization","volume":"143","author":"M Sindou","year":"2020","journal-title":"Brain"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/B978-0-12-819826-1.00021-1","article-title":"Mapping and monitoring of brainstem surgery","volume":"186","author":"K Kodama","year":"2022","journal-title":"Handb Clin Neurol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/WNP.0000000000001037","article-title":"Intraoperative neurophysiologic monitoring and mapping in children undergoing brainstem surgery","volume":"41","author":"V Deletis","year":"2024","journal-title":"J Clin Neurophysiol"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1007\/s00701-024-06323-4","article-title":"Technical report on intra-operative trigeminal root mapping in percutaneous lesioning for trigeminal neuralgias","volume":"166","author":"M Sindou","year":"2024","journal-title":"Acta Neurochir (Wien)"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.clinph.2022.02.004","article-title":"Methodology for eliciting the brainstem trigeminal-hypoglossal reflex in humans under general anesthesia","volume":"137","author":"A Mirallave Pescador","year":"2022","journal-title":"Clin Neurophysiol"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.brs.2022.03.003","article-title":"Long latency responses in tongue muscle elicited by various stimulation sites in anesthetized humans - 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