December 2020


In this letter from the Neurosurgical Health Care System of Northern Italy, the authors addressed the COVID-19 crisis and how to continue operating neurooncological cases that cannot wait for surgery.

The authors explain honestly and clearly how to organize the intraoperative neurophysiological team.  They propose a system to optimize the IONM capacity, in the middle of the pandemic, in a stressed and overload health system with COVID-19 cases.

They tried to keep the standard of IONM from the neurooncological standpoint, to resect as much as a tumor as possible, minimizing the neurological damage.

Unfortunately, this issue is still relevant. We are currently facing a second wave of the pandemic that is striking the northern hemisphere, and in a few weeks, the southern hemisphere.


Francisco Soto

M.D. Neurologist

Past President of the ISIN



ISIN SEP Recommendations



  • This article reviews and forms recommendations for intraoperative SEPs.
  • It endorses SEP optimization to enhance surgical feedback speed and accuracy.
  • It supports an adaptive warning criterion to adjust for baseline drift and variability.

Click here for the full article.