Now used worldwide as an effective tool for intraoperative monitoring (IOM) of the spinal cord, the D185 MultiPulse Cortical Electrical Stimulator is the ONLY standalone surgical stimulator with FDA clearance for this technique.
The D185 MultiPulse Cortical Electrical Stimulator allows transcranial motor evoked potentials (MEPs) to be used in surgical procedures such as scoliosis correction, spinal tumour resection and thoraco-abdominal aortic aneurysm (TAAA) repair. The 1000V power source means that MEPs can even be evoked in patients with pre-existing neuropathologies.
The D185 MultiPulse Cortical Electrical Stimulator is also useful for peripheral nerve stimulation. Although the D185 was designed for transcranial cortical stimulation during intraoperative monitoring, the brief high voltage output also makes it suitable for use as a spinal root stimulator during differential diagnosis of peripheral nerve disorders, such as multifocal motor neuropathy and motor neuron disease. The high voltage allows effectively stimulation of deep nerve roots as they exit the spinal column, while the very short pulse duration minimizes patient discomfort.
MultiPulse Stimulator D185 Mk.IIa
D185 Electrode Holders
D185 MEP Connection Headboxes
Insertion of D185 Stimulus Output Connector
Publications which cite use of the Digitimer D185 can be found on Google Scholar.
- Mains (Power) lead
- Operator’s Manual
The D185 MultiPulse Cortical Electrical Stimulator can be supplied with a range of accessories to facilitate integration with your current operating theatre equipment and stimulation preferences. The current range includes electrode extension leads, stimulator output plugs, a footswitch and a range of electrode connection head boxes and electrode holders/handles for peripheral nerve stimulation applications.
Electrode Connection Headboxes
The D185 has certain safety limits that prevent excessive energy from being delivered to the patient. If you set the D185 to Normal mode and try to deliver too many pulses at too high a voltage, the unit will give an ERROR. You should consult the section titled Operating Modes in the D185 Operator’s Manual where you will find a graph that illustrated what these limits are.
Before you suspect any faults with the stimulator or cable, you should confirm that you have inserted the moulded plug of the extension cable correctly into the output socket on the front of the stimulator. When the plug mates with the output socket, it can be partly inserted with very little force, however, this does not provide a good electrical connection. For a complete electrical connection, further force is required and this supplement to the D185 users manual illustrates how the plug should be correctly inserted.
Yes, the D185-HB3 was specifically designed with this problem in mind. The D185-HB3 headbox incorporates 5 pairs of MEP output sockets as well as 6 channels of isolation for SEP electrodes. If the SEP electrodes are connected through the D185-HB3, they are briefly isolated while an MEP stimulus is passed. This prevents the EP system from “seeing” the MEP stimulus artefact and thus stops the amplifier from saturating/blocking for any length of time. You can read more about the D185-HB3 on the D185 page.
This is very much a decision that only you as the user can make, however we do supply a range of different accessories which start with the basic D185-HB4 which is essentially an output extension lead and end with the D185-HB3 which has 5 pairs of output sockets, a means of isolating SEP recording electrodes during MEP stimulus and a handheld trigger/polarity switching unit (D185-CB1) which allows the operator to easily trigger the D185. More detailed information on the accessories is available on the main D185 page.