[Spinal and subcortical somatosensory evoked potentials: a comparison with the localization of spinal, medullary and pontine lesions and in brain death].

Abstract

The spinal and subcortical median nerve SEPs were recorded in 65 patients with lesions of the cervical cord, medulla oblongata, pons and in brain death. A recording technique including cephalic, non-cephalic and anterior neck referenced leads was used. The location of the lesions corresponded to different types of SEP alterations: Cervical extramedullary lesions compressing the spinal cord corresponded to a prolonged P9-P14 interpeak latency. Cervical intramedullary lesions corresponded to the loss of N13, normally generated in the spinal interneurons. Vascular lesions of the medulla oblongata (Wallenberg's syndrome) showed normal SEPs. Space occupying medulla oblongata lesions corresponded to reduction in amplitude or loss of P14. Pontine lesions showed normal spinal and subcortical SEPs. In brain death P14 showed a graduate decrease in amplitude or alternatively vanished abruptly. The spinal and subcortical SEPs provide a good tool for testing the function of the lemniscal pathways and the spinal interneurons.