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Japanese

SHORT LATENCY SOMATOSENSORY EVOKED POTENTIALS IN PATIENTS WITH SYRINGOMYELIA Shinji Nagahiro 1 , Yasuhiko Matsukado 1 , Shinichi Wada 1 , Eiichiro Urasaki 1 , Akinobu Fukumura 2 1Department of Neurosurgery, Kumamoto University Medical School 2Department of Neurosurgery, Shimonoseki Kosei Hospital pp.1057-1063
Published Date 1986/11/1
DOI https://doi.org/10.11477/mf.1406205806
  • Abstract
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Short latency somatosensory evoked potentials (SSEPs) following median nerve and posteriortibial nerve stimulation were studied in six pa-tients with syringomyelia. Three patients had Chiari malformations, two patients experienced fracture of the spine and one patient had a cauda equina ependymoma.

SSEPs following median nerve stimulation were abnormal in all patients, of which five patients showed abnormal SSEPs only in the unilateral stimulation on the side of sensory deficits. SSEPs obtained from three out of eight upper extremities which showed no disturbance of deep sensation, were abnormal, so SSEPs were able to detect subcli-nical abnormality indicating dorsal column dysfunc-tion. Abnormal patterns of SSEPs were classified in three types as followes; Type 1: disappearance of P13, N16 and N18 (3 cases), Type 2: the prolonged interpeak latency P11-P13 (2 cases), and Type 3: abnormal N16 and N18 with preserving P13 (1 case with Chiari malformation). P9 and P11 were pre-sent without prolonged latencies in all cases.

SSEPs following posterior tibial nerve stimula-tion were abnormal in two of the three tested patients. Those two patients had disturbance of deep sensations in the lower extremities.

All patients underwent surgical treatment, syringo-peritoneal shunt in four patients, foramen magnum decomopression with syringo-subarach-noid shunt in one patient, and total removal of an ependymoma of the cauda equina with syringo-stomy in one patient. Postoperative neurological improvement were found in three patients, of which two cases also showed improvement in SSEPs. On the contrary SSEPs were unchanged in two patients with posttraumatic syringomyelia, whose postoperative neurological condition was also unchanged. SSEPs were directly recorded from the cuneate nucleus for the intraoperative monitoring during syringostomy in one patient.

Analysis of SSEPs in patients with syringomylia is useful for evaluating the function of the dorsal column to the medial lemniscus before, during and after surgery.


Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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