ABSTRACT
Intraoperative neurophysiological monitoring (INM) is underutilized during the anteromesial temporal resection (AMTR) in epilepsy surgery. Herein we report a case with intraoperative capsular infarction which was early detected by INM. Among the modalities of INM, left motor evoked potentials (MEP) showed suddenly decreased amplitude of compound muscle action potentials, after the electrocoagulation in left mesial temporal areas. Postoperative neurologic and MRI findings were well correlated to the intraoperative MEP features. We also discuss the usefulness of INM during the AMTR.
ABSTRACT
The recent advancement of Assisted Reproductive Techniques (ART) has been problematic for the diagnosis and treatment of male infertility. Instead of exploring in depth the nature of the male infertility to achieve a natural pregnancy, ART concentrates mainly on obtaining a sperm for the purpose of fertilizing the ovum. This approach favors fertilization over the correction of male infertility and therefore often overlooks appropriate treatment options. In other words, ART is not consistent with bioethical practices and can lead to unfortunate outcomes for many infertile men. In particular, varicocelectomy, vasovasostomy, and epididymovasostomy result in high pregnancy rates when compared with ART. Moreover, redo-vasovasostomy has also been found to produce high pregnancy rates when the first trial proved unsuccessful. Twenty-five percent of male infertility cases diagnosed by semen analysis are deemed idiopathic. For the remaining seventy-five percent, however, the cause of infertility can be identified. Therefore, the primary approach to infertility should be to treat the underlying cause and thereby enable natural pregnancy to occur.