Caramelli Riccardo, Del Corso Francesca, Schiavone Vincenza, Fossi Selvaggia, Cassardo Annalisa, Pinto Francesco, de Scisciolo Giuseppe
Neurophysiology Unit, Department of Neurology and Psychiatry, Azienda Ospedaliera Careggi, Florence, Italy.
J Clin Neurophysiol. 2006 Oct;23(5):482-5. doi: 10.1097/01.wnp.0000214401.00968.29.
We examined 19 subjects with meralgia paresthetica (bilateral in three cases), recording bilateral somatosensory-evoked potentials (SSEPs) after stimulation of the tibial posterior nerve (TPN) and cutaneous stimulation in the region of the lateral femoral cutaneous nerve (LFCN). We calculated the difference between TPN SSEPs and LFCN SSEPs cortical potentials, identifying a temporal parameter that we termed D(SEP). We defined D(SEP) normal values in a control group. D(SEP) evaluation showed good sensitivity and specificity (85.7% and 82.4%, respectively; accuracy, 83.3%) in discriminating affected limbs from unaffected. The main advantage of this method is to disengage from the necessity of contralateral comparison of LFCN recordings, joined with a reduction of interindividual variability of LFCN SSEPs amplitude and latency that often causes a lower sensitivity of other methods. As an interesting consideration, D(SEP) evaluation appears to mark out a possible subclinical involvement of LFCN in the asymptomatic side of patients with meralgia paresthetica.
我们检查了19例感觉异常性股痛患者(3例为双侧),在刺激胫后神经(TPN)和股外侧皮神经(LFCN)区域进行皮肤刺激后记录双侧体感诱发电位(SSEPs)。我们计算了TPN SSEPs与LFCN SSEPs皮质电位之间的差异,确定了一个我们称为D(SEP)的时间参数。我们在对照组中定义了D(SEP)的正常值。D(SEP)评估在区分患侧肢体与未患侧肢体方面显示出良好的敏感性和特异性(分别为85.7%和82.4%;准确性为83.3%)。该方法的主要优点是无需对LFCN记录进行对侧比较,同时减少了LFCN SSEPs振幅和潜伏期的个体间变异性,而这种变异性常常导致其他方法的敏感性较低。一个有趣的发现是,D(SEP)评估似乎表明感觉异常性股痛患者无症状侧的LFCN可能存在亚临床受累。