Somatosensory evoked potentials in man: differentiation of spinal pathways responsible for conduction from the forelimb vs hindlimb.

This review suggests that a previously unrecognized spinal cord pathway may be of major importance in the conduction of the somatosensory evoked potential (SEP) from the lower limb in Man. The nerve fiber type activated by a "typical" peripheral nerve stimulus used in studying the SEP will activate the posterior tibial nerve or median nerve predominantly at group I threshold. Group I fibers subserve limb proprioception. Therefore the spinal cord pathways subserving limb position sense will be the same pathways activated by a peripheral nerve stimulus used to evoke an SEP. A relatively newly recognized pathway involved with limb position sense from the lower limb is located in the dorsal portion of the lateral funiculus of the spinal cord whereas pathways subserving limb position sense in forelimb involve predominantly the dorsal column pathways. It is suggested that the dorsal columns play no major role in limb position sense from the lower limb in Man and therefore, the dorsal columns play no major role in the conduction of activity from the lower limb involved with the generation of an SEP.