title: Comparison of LEP and QST and their contribution to standard sensory diagnostic assessment of spinal lesions: a pilot study.
abstract: This study evaluates the additional use of laser-evoked potentials (LEP) and quantitative sensory testing (QST) in the sensory assessment of spinal lesions. Four consecutive patients with spinal lesions verified by MRI and clinical evidence for mild spinothalamic tract involvement were included. The electrophysiological workup [somatosensory evoked potentials (SEP) and LEP] was compared to QST. Electrophysiology and QST were reassessed after about 6 months. LEP detected impaired spinothalamic tract function in 7/8 examinations. QST pointed to spinothalamic tract lesions by loss of thermal function (3/8); most frequent positive sensory signs (3/8) were paradoxical heat sensations. LEP and QST results were concordant in 6/8 examinations. SEPs were abnormal in 2/8 examinations. Congruent results between SEP and both LEP and QST were obtained in 3/8 examinations. LEP detected more deficits than any single QST parameter or their combination but additional QST allows the detection of positive sensory signs. The diagnostic gain of SEP was limited.
authors.affiliation: Klinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg Universität, Langenbeckstrasse 1, 55131 Mainz, Germany. geber@uni-mainz.de
authors.forename: Christian
authors.initials: C
authors.lastname: Geber
authors.forename: Ulf
authors.initials: U
authors.lastname: Baumgärtner
authors.forename: Marcel
authors.initials: M
authors.lastname: Fechir
authors.forename: Thomas
authors.initials: T
authors.lastname: Vogt
authors.forename: Frank
authors.initials: F
authors.lastname: Birklein
authors.forename: Rolf-Detlef
authors.initials: RD
authors.lastname: Treede
mesh_terms: D000328:Adult; D004568:Electrodiagnosis / Q000379:methods; D005073:Evoked Potentials, Somatosensory / Q000502:physiology* / Q000528:radiation effects*; D005260:Female; D006801:Humans; D007834:Lasers; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D010147:Pain Measurement / Q000379:methods; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012684:Sensory Thresholds / Q000502:physiology* / Q000528:radiation effects*; D020886:Somatosensory Disorders / Q000175:diagnosis* / Q000503:physiopathology; D013118:Spinal Cord Diseases / Q000175:diagnosis* / Q000503:physiopathology