title: Somatosensory evoked potentials after multisegmental lower limb stimulation in focal lesions of the lumbosacral spinal cord.
abstract: OBJECTIVE
  Recording techniques permit the separate analysis of the response from cauda equina roots and the spinal potential that is probably generated by the activation of dorsal horn cells. To improve the functional assessment of focal lesions of the lumbosacral cord, lower limb somatosensory evoked potentials (SEPs) were measured by multisegmental stimulation.
  
  
  METHODS
  Common peroneal and tibial nerves SEPs were recorded in 14 patients in whom MRI demonstrated compressive cord damage ranging from T9 to L1 levels. SEPs were recorded in each patient at the lumbar level (cauda equina response), lower thoracic level (spinal response), and from the scalp (cortical response).
  
  
  RESULTS
  Abnormalities in spinal response occurred in 50% and 70% of tibial and common peroneal nerve SEPs respectively; these findings were well explained by the radiological compression level, involving in most of the patients lumbar rather than sacral myelomeres. The SEPs were often more effective than the clinical examination in showing the actual extension of damage.
  
  
  CONCLUSIONS
  The recording of spinal SEPs after multisegmental lower limb stimulation proved useful in assessing cord dysfunction and determining the cord levels mainly involved by the compression.
authors.affiliation: Department of Neurology, Università Cattolica del Sacro Cuore, Roma, Italy. drestucia@pelagus.it
authors.forename: D
authors.initials: D
authors.lastname: Restuccia
authors.forename: A
authors.initials: A
authors.lastname: Insola
authors.forename: M
authors.initials: M
authors.lastname: Valeriani
authors.forename: V
authors.initials: V
authors.lastname: Santilli
authors.forename: L
authors.initials: L
authors.lastname: Bedini
authors.forename: D
authors.initials: D
authors.lastname: Le Pera
authors.forename: C
authors.initials: C
authors.lastname: Barba
authors.forename: F
authors.initials: F
authors.lastname: Denaro
authors.forename: P
authors.initials: P
authors.lastname: Tonali
mesh_terms: D000328:Adult; D000368:Aged; D002420:Cauda Equina / Q000503:physiopathology*; D004558:Electric Stimulation; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010543:Peroneal Nerve / Q000503:physiopathology; D013116:Spinal Cord / Q000503:physiopathology*; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D013979:Tibial Nerve / Q000503:physiopathology