Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Changes in Dermatomal Somatosensory Evoked Potentials according to Stimulation Intensity and Severity of Carpal Tunnel Syndrome

  • Sohn, Soo-Youn (Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital) ;
  • Seo, Jeong-Hwan (Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital) ;
  • Min, Yong (Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital) ;
  • Seo, Min-Ho (Department of Physical Medicine and Rehabilitation, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital) ;
  • Eun, Jong-Pil (Department of Neurosurgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital) ;
  • Song, Kyung-Jin (Department of Orthopedic Surgery, Research Institute of Clinical Medicine, Chonbuk National University Medical School and Hospital)
  • Received : 2011.11.29
  • Accepted : 2012.05.18
  • Published : 2012.05.28
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Abstract

Objective : To investigate the change of latency of cervical dermatomal somatosensory evoked potential (DSEP) according to stimulation intensity (SI) and severity of carpal tunnel syndrome (CTS). Methods : Stimulation sites were the C6, C7, and C8 dermatomal areas. Two stimulation intensities $1.5{\times}$sensory threshold (ST) and $2.5{\times}ST$ were used on both normal and CTS patients. Results : In moderate CTS, the latencies of C6 and C7 DSEP during $1.5{\times}ST$ SI and those of C7 DSEP during $2.5{\times}ST$ SI were significantly delayed compared with the values of normal subjects. Significant correlation between the latency of C7 DSEP of $2.5{\times}ST$ stimulation and the median sensory nerve conduction velocity was observed. Conclusion : We suggest that these data can aid in the diagnosis of cervical sensory radiculopathy using low stimulation intensity and of those who have cervical sensory radiculopathy combined with CTS patients.

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References

  1. Aminoff MJ, Goodin DS, Barbaro NM, Weinstein PR, Rosenblum ML : Dermatomal somatosensory evoked potentials in unilateral lumbosacral radiculopathy. Ann Neurol 17 : 171-176, 1985 https://doi.org/10.1002/ana.410170211
  2. Burke D, Skuse NF, Lethlean AK : Cutaneous and muscle afferent components of the cerebral potential evoked by electrical stimulation of human peripheral nerves. Electroencephalogr Clin Neurophysiol 51 : 579-588, 1981 https://doi.org/10.1016/0013-4694(81)90202-9
  3. Date ES, Ortega HR, Hall K, Rappaport M : Somatosensory evoked responses to dermatomal stimulation in cervical spinal cord injured and normal subjects. Clin Electroencephalogr 19 : 144-154, 1998
  4. Dawson GD : Cerebral response to electrical stimulation of peripheral nerve in man. J Neurol Neurosurg Psysical 10 : 134-140, 1947 https://doi.org/10.1136/jnnp.10.3.134
  5. Deletis V, Srala F : Intraoperative neurophysiological monitoring of the spinal cord during spinal cord and spine surgery : a review focus on the corticospinal tracts. Clin Neurophysiol 119 : 248-264, 2008 https://doi.org/10.1016/j.clinph.2007.09.135
  6. Han TR, Kim JH, Kim HS : The significance of somatosensory evoked potential test in peripheral nerve injury. J Korean Acad Rehabil Med 15 : 287-294, 1991
  7. Katifi HA, Sedgwick EM : Somatosensory evoked potentials from posterior tibial nerve and lumbo-sacral dermatomes. Electroencephalogr Clin Neurophysiol 65 : 249-259, 1986 https://doi.org/10.1016/0168-5597(86)90002-X
  8. Kwon HK, Hwang MR, Yoon DW. Frequency and severity of carpal tunnel syndrome according to level of cervical radiculopathy : double crush syndrome? Clin Neurophysiol 117 : 1256-1259, 2006 https://doi.org/10.1016/j.clinph.2006.02.013
  9. Napadow V, Kettner N, Ryan A, Kwong KK, Audette J, Hui KK : Somatosensory cortical plasticity in carpal tunnel syndrome--a cross-sectional fMRI evaluation. Neuroimage 31 : 520-530, 2006 https://doi.org/10.1016/j.neuroimage.2005.12.017
  10. Owen JH, Padberg AM, Spahr-Holland L, Bridwell KH, Keppler L, Steffee AD : Clinical correlation between degenerative spine disease and dermatomal somatosensory-evoked potentials in humans. Spine (Phila Pa 1976) 16 : S201-S205, 1991 https://doi.org/10.1097/00007632-199106001-00005
  11. Ra UW, Moon JH, Park ES, Cho KJ : Diagnosis of sensory radiculopathy after laminectomy. J Korean Acad Rehab Med 8 : 26-33, 1984
  12. Rodriquez AA, Kanis L, Rodriquez AA, Lane D : Somatosensory evoked potentials from dermatomal stimulation as an indicator of L5 and S1 radiculopathy. Arch Phys Med Rehabil 68 : 366-368, 1987
  13. Seo JH, Kim JY, Ko MH, Eun JP : Diagnostic usefulness of dermatomal somatosensory evoked potentials by low intensity stimulation in lumbar radiculopathy. J Korean Acad Rehab Med 31 : 341-345, 2007
  14. Steven JC : AAEM minimonograph #26 : the electrodiagnosis of carpal tunnel syndrome. American Association of Electrodiagnostic Medicine. Muscle Nerve 20 : 1477-1486, 1997 https://doi.org/10.1002/(SICI)1097-4598(199712)20:12<1477::AID-MUS1>3.0.CO;2-5
  15. Sunderland S : Anatomical features of nerve trunks in relation to nerve injury and nerve repair. Clin Neruosurg 17 : 38-62, 1970 https://doi.org/10.1093/neurosurgery/17.CN_suppl_1.38
  16. Sunderland S: The nerve lesion in the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 39 : 615-626, 1976 https://doi.org/10.1136/jnnp.39.7.615
  17. Tinazzi M, Zanette G, Volpato D, Testoni R, Bonato C, Manganotti P, et al. : Neurophysiological evidence of neuroplasticity at multiple levels of the somatosensory system in patients with carpal tunnel syndrome. Brain 121 : 1785-1794, 1998 https://doi.org/10.1093/brain/121.9.1785
  18. Tsai TM, Tsai CL, Lin TS, Lin CC, Jou IM : Value of dermatomal somatosensory evoked potentials in detecting acute nerve root injury: an experimental study with special emphasis on stimulus intensity. Spine (Phila Pa 1976) 30 : E540-E546, 2005 https://doi.org/10.1097/01.brs.0000179311.87137.0d
  19. Yazicioglu K, Ozgul A, Kalyon TA, Gunduz S, Arpacioglu O, Bilgic F : The diagnostic value of dermatomal somatosensory evoked potentials in lumbosacral disc herniations : a critical approach. Electromyogr Clin Neurophysiol 39 : 175-181, 1999

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