Sensorimotor and auditory central conduction time in locked-in syndrome.
Motor evoked potentials (MEPs) following magnetic cortical stimulation, somatosensory evoked potentials from median nerve (SEP) and auditory brain-stem responses (ABR) were recorded in a patient with locked-in syndrome during the acute and chronic phases of the clinical course. During the acute phase both ABR and SEP were normal. The MEP from the right upper limb showed a delayed and low voltage potential, while that from the left upper limb was absent. The CT scan showed a ponto-mesencephalic hypodensity. In the chronic phase the MEP from the left upper limb had reappeared and showed a normal latency, while the one from the right upper limb worsened; at that time a new small left fronto-parietal hypodensity had appeared on CT scan. The combined use of MEP, SEP and ABR was able to confirm that the brain-stem damage involved the pyramidal but spared the lemniscal pathways, while MEP changes during the clinical course appeared to reflect both clinical and radiological findings.
Facco
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E
Department of Anesthesiology and Intensive Care, University of Padua, Italy.
Caputo
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P
Fiore
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Giron
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GP
D001933:Brain Stem / Q000502:physiology; D005071:Evoked Potentials / Q000502:physiology; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005133:Eye Movements / Q000502:physiology*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000502:physiology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010243:Paralysis / Q000503:physiopathology*; D013577:Syndrome