[Prognosis of traumatic spinal cord lesions. Significance of clinical and electrophysiological findings].
The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques (somatosensory-evoked potentials (SSEP), motor-evoked potentials (MEP), electroneurography) to assess the extent and severity of a spinal cord injury. As essential advantage of these techniques in comparison with the clinical examination is that they can be reliably applied even in uncooperative patients. These techniques allow an early prognosis of the functional deficit in patients with acute spinal cord injury. Recordings of tibial nerve SSEP and MEP of the anterior tibial muscle allow to predict the outcome of ambulatory capacity, while recordings of pudendal nerve SSEP allow prognosis of the bladder function to be assessed. In tetraplegic patients median and ulnar nerve SSEP and MEP of the abductor digiti minimi muscle can indicate the development of hand function. Electroneurography allows to differentiate between the proportion of peripheral and central nervous lesions underlying the muscle paresis. This is of prognostic value with regard to the development of muscle tone and consequently for planning therapy. The electrophysiological examinations are of complementary value in the diagnostic assessment of spinal cord lesions, in the prediction of functional outcome, and in monitoring the course of neurological deficits. This is helpful for planning and selection of appropriate therapeutic approaches (e.g. functional electrical stimulation, application of botulinum toxin, splinting procedures) within the rehabilitation programme.
Curt
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Schweizerisches Paraplegikerzentrum, Universitätsklinik Balgrist, Zürich.
Dietz
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D000203:Activities of Daily Living / Q000145:classification; D000818:Animals; D004568:Electrodiagnosis; D006801:Humans; D009460:Neurologic Examination; D011379:Prognosis; D013116:Spinal Cord / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000145:classification / Q000503:physiopathology / Q000534:rehabilitation*; D009435:Synaptic Transmission / Q000502:physiology