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Evaluation of Radiculopathies by Segmental Stimulation and Somatosensory Evoked Potentials

Published online by Cambridge University Press:  18 September 2015

Andrew Eisen ,
Maureen Hoirch  and
Alex Moll
Andrew Eisen*
Affiliation:
Department of Diagnostic Neurophysiology, Vancouver General Hospital, Vancouver, B.C.
Maureen Hoirch
Affiliation:
Department of Diagnostic Neurophysiology, Vancouver General Hospital, Vancouver, B.C.
Alex Moll
Affiliation:
Department of Diagnostic Neurophysiology, Vancouver General Hospital, Vancouver, B.C.
*
Diagnostic Neurophysiology — EMG, Vancouver General Hospital, 855 West 12th Avenue, Vancouver, B.C. V5Z 1M9.
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Thirty-six patients with suspected or myelographically proven radiculopathies were investigated with motor and sensory conductions, F-waves, needle electromyography, and somatosensory evoked potentials (SEPs). SEPs were elicited by cutaneous nerve stimulation representative of input from individual cervical and lumbosacral dorsal roots. A myelographic defect was present in 83% of 30 patients who had myelograms. Overall 78% of patients had one or more abnormal electrophysiologic tests, the needle EMG giving the best diagnostic yield (75%). F-waves and SEPs were abnormal in 43% and 57% of cases respectively. Motor deficit correlated best with abnormal EMGs, whilst abnormal SEPs occurred most frequently when sensory deficit predominated. Prolonged latency of the SEP occurred rarely, reduced amplitude or abnormal morphology being the most useful characteristics. SEPs evoked by cutaneous nerve stimulation are a useful addition to conventionally available electrophysiological methods of evaluating radiculopathies, especially in the absence of motor deficit.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 10 , Issue 3 , August 1983 , pp. 178 - 182
Copyright
Copyright © Canadian Neurological Sciences Federation 1983

References

Asbury, A.K. (1977). Proximal diabetic neuropathy. Ann Neurol, 2(3); 179–180.CrossRefGoogle ScholarPubMed
Braddom, R.L., and Johnson, E.W. (1974a). Standadization of H reflex and diagnostic use in SI radiculopathy. Arch. Phys. Med. Rehabil., 55: 161–166.Google Scholar
Braddom, R.L., and Johnson, E.W. (1974b). H reflex: Review and classification with suggested clinical uses. Arch. Phys. Med. Rehabil., 55: 412–417.Google ScholarPubMed
Buchthal, F., Rosenfalck, A., and Behse, F. (1975). Sensory potentials of normal and diseased nerve. In: Peripheral Neuropathy, vol. 1, p. 422, edited by Dyck, P.J., Thomas, P.K., and Lambert, E.H.. Saunders, Philadelphia.Google Scholar
Burke, D., Skuse, N.F., and Lethlean, A.K. (1981). Cutaneous and muscle afferent components of the cerebral potential evoked by electrical stimulation of human peripheral nerve. Electroencephalogr. Clin. Neurophysiol., 51: 579–588.CrossRefGoogle Scholar
Chiappa, K.H., and Ropper, A.L. (1982). Evoked potentials in clinical medicine (part two). N. Engl. J. Med., 306: 1205–1211.CrossRefGoogle Scholar
Eisen, A., Schomer, D., and Melmed, C. (1977a). The application of F-wave measurements in the differentiation of proximal and distal upper limb entrapments. Neurology, 27: 662–668.Google ScholarPubMed
Eisen, A., Schomer, D., and Melmed, C. (1977b). An electrophysiological method for examining lumbosacral root compression. Can. Neurol. Sci., 4: 117–123.CrossRefGoogle ScholarPubMed
Eisen, A., and Elleker, G. (1980). Sensory nerve stimulation and evoked cerebral potentials. Neurology, 30: 1097–1105.CrossRefGoogle ScholarPubMed
El Negamy, E., and Sedgwick, E.M. (1979). Delayed cervical somatosensory potentials in cervical spondylosis. J. Neurol. Neurosurg. Psychiatry, 42:238–241.CrossRefGoogle ScholarPubMed
Fisher, M.A., Shivde, A.J., Teixera, C., and Grainer, L.S. (1978). Clinical and electrophysiological appraisal of the significance of radicular injury in back pain. J. Neurol., Neurosurg. Psychiatry, 41: 303–306.CrossRefGoogle ScholarPubMed
Gandevia, S., Burke, D., and McKeon, B. (1982). The relationship between the size of a muscle afferent volley and the cerebral potential it produces. J. Neurol., Neurosurg. Psychiatry, 45: 705–710.CrossRefGoogle ScholarPubMed
Ganes, T. (1980). Somatosensory conduction times and peripheral cervical and cortical evoked potentials in patients with cervical spondylosis. Neurol. Neurosurg. Psychiatry, 43: 683–689.CrossRefGoogle ScholarPubMed
Gough, J. C., and Koepke, G. H. (1966). Electromyographic determination of motor root levels in erector spinae muscles. Arch. Phys. Med. Rehabil., 47: 9–11.Google ScholarPubMed
Johnson, E.W., and Melvin, J.L. (1971). Value of electromyography in lumbar radiculopathy. Arch. Phys. Med. Rehabil., 52: 239–243.Google ScholarPubMed
Jorg, J., Dullberg, W., and Koeppen, S. (1982). Diagnostic value of segmental somatosensory evoked potentials in cases with chronic progressive para-or tetraspastic syndromes. In: Clinical Applications of Evoked Potentials in Neurology, pp. 347–358, edited by Courjon, J., Mauguiere, F., and Revol, M.. New York, Raven Press.Google Scholar
Kimura, J. (1974). F-wave velocity in the central segment of the median and ulnar nerves. A study in normal subjects and in patients with Charcot-Marie-Tooth disease. Neurology, 24: 539–546.CrossRefGoogle ScholarPubMed
Knuttson, B. (1961). Comparative value of electromyographic, myelographic, and clinical-neurological examinations in diagnosis of lumbar root compression syndrome. Acta Orthop. Scand., (suppl.) 49: 1–135.Google Scholar
Ludin, H.P., and Tackmann, W. (1981). Sensory Neurography. New York, Thieme-Stratton Inc., pp.1–123.Google Scholar
Mayer, R.F., and Feldman, R.G. (1967). Observations on the nature of the F-wave in man. Neurology, 17: 147–156.CrossRefGoogle ScholarPubMed
Miglietta, O.E. (1973). The F response after transverse myelotomy. In: New Developments in Electromyography and Clinical Neurophysiology, pp.323–327, edited by Desmedt, J.E.. Karger: Basel.Google Scholar
Namerow, N.S. (1968). Somatosensory evoked responses in multiple sclerosis patients with varying sensory loss. Neurology, 18:1197–1204.Google ScholarPubMed
Roberts, K.B., Lawrence, P.D., and Eisen, A. (1983). Dispersion of the somatosensory evoked potential (SEP) in multiple sclerosis. IEE Trans Biomed Engin (in press).CrossRefGoogle Scholar
Schramm, J., Oettle, G.J., and Pichert, T. (1980). Clinical application of segmental somatosensory evoked potentials (SEP)—experience in patients with non-space occupying lesions. In: Evoked Potentials, pp.455–464, edited by Barber, C.. Lancaster, MTP Press Ltd.Google Scholar
Schuchmann, J.A. (1978). H-reflex latency in radiculopathy. Arch. Phys. Med. Rehabil., 59: 185–187.Google ScholarPubMed
Siivola, J., Salg, I., and Heiskari, M. (1981). Somatosensory evoked potentials in diagnostics of cervical spondylosis and herniated disc.CrossRefGoogle Scholar
Sun, S.F., and Streib, E.W. (1981). Diabetic thoracoabdominal neuropahty Clinical and electrodiagnostic features. Ann. Neurol., 9: 75–79.CrossRefGoogle Scholar
Thomas, J.E., and Howard, F.M. Jr. (1974). Segmental zoster paresis – a disease profile. Neurology, 22: 459–466.CrossRefGoogle Scholar
Tonzola, R.F., Ackil, A.A., Shahani, B.T., and Young, R.R. (1981). Usefulness of electrophysiological studies in the diagnosis of lumbosacral root disease. Ann. Neurol., 9: 305–308.CrossRefGoogle ScholarPubMed