Seyal M, Sandhu L S, Mack Y P
Department of Neurology, University of California, Davis Medical Center, Sacramento 95817.
Neurology. 1989 Jun;39(6):801-5. doi: 10.1212/wnl.39.6.801.
We studied 21 patients with lumbosacral radiculopathy with segmental somatosensory evoked potentials (SEPs) recorded over both spine and scalp following saphenous, superficial peroneal, and sural nerve stimulation. Spinal SEPs were abnormal in 10 patients. In 3 patients, SEPs detected abnormalities not seen on EMG examination. With 1 exception, all anatomic levels of SEP abnormalities matched that of radiographic, EMG, or clinical abnormalities. SEPs were abnormal in 41% of nerve roots shown to be involved by other techniques. SEPs added to the clinical evaluation in 4 patients, but were less accurate than a combination of EMG and radiography in indicating the extent of nerve root involvement. We conclude that spinal SEPs following segmental sensory stimulation are useful in the evaluation of lumbosacral radiculopathies and complement information provided by the EMG. In contrast, scalp-recorded segmental SEPs rarely provide additional useful clinical information.
我们对21例腰骶神经根病患者进行了研究,在隐神经、腓浅神经和腓肠神经刺激后,于脊柱和头皮记录节段性体感诱发电位(SEP)。10例患者的脊髓SEP异常。3例患者中,SEP检测到肌电图检查未发现的异常。除1例例外,SEP异常的所有解剖水平均与影像学、肌电图或临床异常相符。在其他技术显示受累的神经根中,41%的神经根SEP异常。SEP为4例患者的临床评估提供了补充信息,但在指示神经根受累程度方面,其准确性低于肌电图和放射学检查相结合的方法。我们得出结论,节段性感觉刺激后的脊髓SEP有助于评估腰骶神经根病,并补充肌电图提供的信息。相比之下,头皮记录的节段性SEP很少提供额外有用的临床信息。