title: High sensitivity of contact-heat evoked potentials in "snake-eye" appearance myelopathy.
abstract: OBJECTIVE
  To evaluate the sensitivity of dermatomal contact-heat evoked potentials (dCHEPs) compared to dermatomal somatosensory evoked potentials (dSSEPs) and clinical sensory testing in patients with focal central cord myelopathy, referred to as "snake-eye" appearance myelopathy (SEAM).
  
  
  METHODS
  33 patients with SEAM in neuroimaging underwent electrophysiological (dCHEPs, dSSEPs) and clinical testing of sensory function (light touch [LT] and pin prick [PP]) at segments above, at and below to the spinal cord lesion.
  
  
  RESULTS
  In total, 151 dermatomes were tested (39 above, 112 at/below lesion). The sensitivity of dCHEPs (97.0%) was significantly higher compared to dSSEPs (23.3%, p<0.001), PP (66.7%, p=0.003) and LT (69.7%, p=0.006), respectively. The sensitivity of dCHEPs was highest when applied one to two segments caudally to the level of spinal cord lesion in MRI.
  
  
  CONCLUSIONS
  dCHEPs are highly sensitive and superior to dSSEPs and clinical sensory testing in the diagnosis of SEAM.
  
  
  CONCLUSIONS
  dCHEPs may complement the diagnosis in focal central cord myelopathies where clinical testing of sensory function and dSSEPs are less sensitive to provide conclusive findings.
authors.affiliation: Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Switzerland. Electronic address: ulrich.anett@gmx.de.
authors.forename: A
authors.initials: A
authors.lastname: Ulrich
authors.affiliation: Department of Orthopedic Surgery, Balgrist University Hospital, University of Zurich, Switzerland.
authors.forename: K
authors.initials: K
authors.lastname: Min
authors.affiliation: Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Curt
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000175:diagnosis / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000503:physiopathology*; D055815:Young Adult
keywords: Central cord myelopathy; Contact-heat evoked potentials; Snake-eye appearance myelopathy; Somatosensory evoked potentials; Spinothalamic tract