[Neurological diagnosis and prognosis: significance of neurophysiological findings in traumatic spinal cord lesions].
The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques (somatosensory evoked potentials [SSEP], motor evoked potentials [MEP], and electroneuromyographic recordings [ENMG]) to assess the extent and severity of a spinal cord injury. An essential advantage of these techniques in comparison with clinical examination is that they can also be reliably applied in uncooperative patients. These techniques allow early prognosis regarding the functional deficit in patients with acute spinal cord injury. Recordings of tibial nerve somatosensory evoked potentials and motor evoked potentials of the anterior tibial muscle serve to predict the outcome of ambulatory capacity, and pudendal nerve somatosensory evoked potentials that of bladder function. In tetraplegic patients median and ulnar nerve somatosensory evoked potentials and motor evoked potentials of the abductor digiti min. muscle may indicate the outcome of hand function at an early stage. The electroneuromyographic recordings make it possible to differentiate between the proportion of peripheral and central nervous lesion underlying a muscle paresis. This is of prognostic value in regard to the development of muscle tone and consequently for planning of 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 within the rehabilitation programme.
Curt
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Schweizerisches Paraplegikerzentrum, Universitätsklinik Balgrist, Zürich.
D004568:Electrodiagnosis; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D006801:Humans; D009460:Neurologic Examination; D010525:Peripheral Nerves / Q000503:physiopathology; D011379:Prognosis; D013116:Spinal Cord / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000503:physiopathology