Penfield's Motor Homunculus Revisited:: MR Prajwal Ghimire
Penfield's Motor Homunculus Revisited:: MR Prajwal Ghimire
Penfield's Motor Homunculus Revisited:: MR Prajwal Ghimire
Mr Prajwal Ghimire
MBBS MRCSEd. MSc
Clinical Fellow and Registrar Neurosurgery
• Post op: T1 post GAD MRI Ghimire P et al. Brain Struct Funct 226, 1601–1611 (2021)
Cortical Motor Mapping
Demographics Data
Mean Age (years) (with Range) 50 (16-79)
Laterality of the lesion N (%)
Right 97 (53.8%)
Left 83 (46.2%)
Gender N (%)
Male 105 (58.4%)
Female 75 (41.6%)
Pathology of the lesion
Glioma
-High Grade (III,IV) 104 (57.7%)
-Low Grade (I,II) 41 (23%)
Meningioma 8 (4.4%)
Metastasis 25 (13.8%)
Vascular malformations 2 (1.1%)
5 -Foot
6,7 – face
• Subcortical motor evoked potentials (scMEPs) were recorded using modified monopolar
suction probe and monopolar probe
Sub-cortical mapping b
1 2
3 4
7 8
13 14
9 10
6,7,8- 5-7mA
9- 4mA
20mA
Face
Green- Superimposed CST model with operating
microscope
• will aid surgical planning for lesions in or around the motor pathways
• to reduce the risks
• increase the extent of resection.
Probabilistic Atlas/Maps