# US 10,478,097 B2 · Neural event detection

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- Number: US 10,478,097 B2
- Document ID: US10478097B2
- Status: Granted
- Kind: B2
- Application number: 13/965,468
- Filed: 2013-08-13
- Published: 2015-02-19
- Granted: 2019-11-19
- Earliest claimed: 2013-08-13
- Assignees: Innovative Surgical Solutions, LLC
- Applicants: Innovative Surgical Solutions, LLC
- Inventors: Christopher Wybo; Darren Scarfe; Aashish Shah
- Web page: https://patentgrep.com/patent/US10478097B2

## CPC

- A61B 5/1106: {to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia}
- A61B 5/1109: {of wounds, e.g. at the operation site}
- A61B 2505/05: Surgical care
- A61B 2562/0204: Acoustic sensors
- A61B 2562/0219: Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
- A61B 2562/0261: Strain gauges
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A neural monitoring system for detecting an artificially-induced mechanical muscle response to a stimulus provided within an intracorporeal treatment area includes a mechanical sensor and a processor in communication with the mechanical sensor. The mechanical sensor is configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle. The processor is configured to receive the mechanomyography output signal from the mechanical sensor and determine a frequency component of the mechanomyography output signal that has a peak magnitude and to detect the occurrence of an artificially-induced mechanical muscle response therefrom.

## Claims

### Claim 1

A neural monitoring system for detecting an artificially-induced mechanical response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject, the intracorporeal treatment area including a nerve that innervates the muscle, the neural monitoring system comprising:
a non-invasive mechanical sensor configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle; and
a processor in communication with the mechanical sensor and configured to:
receive the mechanomyography output signal from the mechanical sensor;
determine a frequency component of the mechanomyography output signal, wherein the frequency component has a peak magnitude relative to adjacent frequencies; and
provide an indication of an artificially induced mechanical muscle response to a user if the determined frequency component has a frequency within the range of greater than 0 Hz to about 20 Hz.

### Claim 2 (depends on 1)

The neural monitoring system of claim 1, wherein the processor is further configured to attenuate frequency content of the mechanomyography output signal that is above a cutoff frequency.

### Claim 3 (depends on 2)

The neural monitoring system of claim 2, wherein the cutoff frequency is in the range of about 20 Hz to about 50 Hz.

### Claim 4 (depends on 1)

The neural monitoring system of claim 1, wherein the processor is configured to determine a frequency component of the mechanomyography output signal that has a peak magnitude by:
converting the received mechanomyography output signal from a time domain to a frequency domain, wherein the frequency domain is characterized by a plurality of discrete frequencies, each having a corresponding magnitude; and
identifying the frequency component from the plurality of discrete frequencies that corresponds to a magnitude peak.

### Claim 5 (depends on 1)

The neural monitoring system of claim 1, wherein the mechanical sensor includes an accelerometer, a microphone, a strain gauge, or a piezoelectric device.

### Claim 6 (depends on 1)

The neural monitoring system of claim 1, wherein the stimulus includes a mechanical manipulation of tissue within the intracorporeal treatment area.

### Claim 7

A neural monitoring system for detecting an artificially-induced mechanical response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject, the intracorporeal treatment area including a nerve that innervates the muscle, the neural monitoring system comprising:
a non-invasive mechanical sensor configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle; and
a processor in communication with the mechanical sensor and configured to:
receive the mechanomyography output signal from the mechanical sensor;
determine a fundamental frequency of the mechanomyography output signal;
provide an indication of an artificially-induced mechanical muscle response to a user if the determined fundamental frequency is within the range of greater than 0 Hz to about 10 Hz.

### Claim 8 (depends on 7)

The neural monitoring system of claim 7, wherein the processor is further configured to attenuate frequency content of the mechanomyography output signal that is above a cutoff frequency.

### Claim 9 (depends on 8)

The neural monitoring system of claim 8, wherein the cutoff frequency is in the range of about 20 Hz to about 50 Hz.

### Claim 10 (depends on 7)

The neural monitoring system of claim 7, wherein the processor is configured to determine a fundamental frequency of the mechanomyography output signal by:
converting the received mechanomyography output signal from a time domain to a frequency domain, wherein the frequency domain is characterized by a plurality of discrete frequencies, each having a corresponding magnitude;
identifying a subset of the plurality of discrete frequencies wherein each discrete frequency belonging to the subset corresponds to a respective magnitude peak; and
determining a greatest common factor of the frequencies belonging to the subset.

### Claim 11 (depends on 7)

The neural monitoring system of claim 7, wherein the mechanical sensor includes an accelerometer, a microphone, a strain gauge, or a piezoelectric device.

### Claim 12 (depends on 7)

The neural monitoring system of claim 7, wherein the stimulus includes a mechanical manipulation of tissue within the intracorporeal treatment area.

### Claim 13

A neural monitoring system for detecting an artificially-induced mechanical response of a muscle to a stimulus provided within an intracorporeal treatment area of a human subject, the intracorporeal treatment area including a nerve that innervates the muscle, the neural monitoring system comprising:
a mechanical sensor configured to be placed in mechanical communication with the muscle and to generate a mechanomyography output signal corresponding to a sensed mechanical movement of the muscle; and
a processor in communication with the mechanical sensor and configured to:
receive the mechanomyography output signal from the mechanical sensor;
convert the received mechanomyography output signal from a time domain to a frequency domain, wherein the frequency domain is characterized by a plurality of discrete frequencies, each having a corresponding magnitude;
provide an indication of an artificially induced mechanical muscle response to a user if the magnitude of at least one of the plurality of discrete frequencies exceeds a threshold, wherein the threshold is above an established noise floor.

### Claim 14 (depends on 13)

The neural monitoring system of claim 13, wherein the threshold is a multiple of the noise floor.

### Claim 15 (depends on 14)

The neural monitoring system of claim 14, wherein the noise floor has a varying magnitude for each of the plurality of discrete frequencies.

### Claim 16 (depends on 14)

The neural monitoring system of claim 14, wherein the processor is configured to indicate that the sensed mechanical movement of the muscle was induced by the provided intracorporeal stimulus if the magnitudes of at least two of the plurality of discrete frequencies exceed the threshold.

### Claim 17 (depends on 16)

The neural monitoring system of claim 16, wherein each of the at least two discrete frequencies is an integer multiple of a fundamental frequency.

### Claim 18 (depends on 13)

The neural monitoring system of claim 13, wherein the at least one frequency is within the range of greater than 0 Hz to about 20 Hz.

### Claim 19 (depends on 13)

The neural monitoring system of claim 13, wherein the stimulus includes a mechanical manipulation of tissue within the intracorporeal treatment area.
