Prieto J, Esteban A
Sección de Neurofisiología Clínica, Hospital General Universitario Gregorio Marañón, Madrid.
Neurologia. 1995 Nov;10(9):355-61.
We studied 13 patients suffering from localized spinal cord lesions by means of somatosensory evoked potentials obtained by electrical stimulation at various dermatome levels (SEPD). The results were compared to those of somatosensory evoked potentials obtained by stimulation of the posterior tibial nerve (SEPpt), as well as to clinical and radiologic data. Structural lesions could be demonstrated in 8 patients; in 5 patients, however, X-rays were normal and/or incompatible with symptoms. We found clear correlations among clinical or radiologic data and the level of lesion indicated by SEPD in all 13 patients. In one case SEPD were abnormal 6 months in advance of the first alteration in magnetic resonance imaging. Abnormal SEPD and SEPpt results were consistent, suggesting the existence of a common central pathway to carry stimuli. SEPD should be considered a useful, reliable technique for assessing spinal cord function, especially when no structural lesion can be demonstrated or when spinal injury is doubtful or when several segments are involved.
我们通过在不同皮节水平进行电刺激获得体感诱发电位（SEPD），对13例患有局限性脊髓损伤的患者进行了研究。将结果与通过刺激胫后神经获得的体感诱发电位（SEPpt）结果以及临床和放射学数据进行了比较。8例患者可证实存在结构性损伤；然而，5例患者的X线检查结果正常和/或与症状不符。我们发现，在所有13例患者中，临床或放射学数据与SEPD所示的损伤水平之间存在明显的相关性。在1例病例中，体感诱发电位在磁共振成像首次出现改变前6个月就表现异常。体感诱发电位和胫后神经体感诱发电位的异常结果一致，提示存在一条传导刺激的共同中枢通路。SEPD应被视为评估脊髓功能的一种有用、可靠的技术，尤其是在无法证实存在结构性损伤、脊髓损伤存疑或涉及多个节段时。
