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Spinal Somatosensory Evoked Potentials in Patients with Tethered Cord Syndrome

Published online by Cambridge University Press:  18 September 2015

Alberto Polo ,
Giampietro Zanette ,
Paolo Manganotti ,
Laura Bertolasi ,
Domenico De Grandis  and
Nicolo’ Rizzuto
Alberto Polo*
Affiliation:
Dipartimento di Scienze Neurologiche E Della Visione, Sezione Neurologia, Università’ Degli Studi di Verona
Giampietro Zanette
Affiliation:
Dipartimento di Scienze Neurologiche E Della Visione, Sezione Neurologia, Università’ Degli Studi di Verona
Paolo Manganotti
Affiliation:
Dipartimento di Scienze Neurologiche E Della Visione, Sezione Neurologia, Università’ Degli Studi di Verona
Laura Bertolasi
Affiliation:
Dipartimento di Scienze Neurologiche E Della Visione, Sezione Neurologia, Università’ Degli Studi di Verona
Domenico De Grandis
Affiliation:
Divisione di Neurologia, Arcispedale S. Anna, Ferrara
Nicolo’ Rizzuto
Affiliation:
Divisione di Neurologia, Arcispedale S. Anna, Ferrara
*
Dipartimento di Scienze Neurologiche E Della Visione, Sezione Neurologia, Universita’ Degli Studi di Verona, Policlinico Borgo Roma, via Delle Menegone, 37134 – Verona, Italy
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Abstract:

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We studied the electrophysiological changes occurring in six patients with tethered cord syndrome. Evidence of spinal malformations was provided by magnetic resonance imaging. The functional assessment of the spinal cord was performed by analysing both spinal and cortical somatosensory evoked potentials. The evoked electrospinogram was recorded from the thoracic and lumbosacral spinous processes. The N22 lumbosacral potential was selectively affected, being rostrocaudally displaced and reduced in amplitude or even absent in patients with neurological signs indicating a segmental lower cord lesion. Inter-peak somatosensory evoked potentials latency was normal in all cases, suggesting that ascending axonal potentials in the dorsal column fibres may be synchronized. Segmental potentials of the lumbosacral response, originating from the post-synaptic activity of dorsal horn interneurons, are selectively affected in this syndrome resulting from the rostrocaudal displacement of the spinal cord due to tethering. Our findings in the clinical field are consistent with previous experimental evidence indicating a different sensitivity of the gray vs. white matter to progressive stretching.

Résumé:

Résumé:

Potentiels évoqués somesthésiques spinaux chez les patients atteints du syndrome du filum terminale. Nous avons étudié les changements électrophysiologiques présents chez six patients atteints du syndrome du filum terminale. Les malformations médullaires étaient détectées par résonance magnétique nucléaire. L’évaluation fonctionnelle de la moelle épiniere était effectuée par l’analyse des potentiels évoqués somesthésiques spinaux et corticaux (PES). L’électrospinogramme évoqué était enregistré au niveau des apophyses épineuses thoraciques et lombosacrées. Le potentiel lombosacré N22 était sélectivement atteint: il était déplacé en position rostrocaudale et son amplitude était réduite et il était absent chez les patients qui avaient des signes neurologiques indiquant une lésion segmentaire basse de la moelle épiniere. La latence interpics des PES était normale chez tous les cas suggérant que les potentiels axonaux ascendants des fibres du faisceau postérieur sont synchronisés. Les potentiels segmentates de la réponse lombosacrée originant de l’activité post-synaptique des neurones intercalaires de la corne postérieure de la moelle sont atteints sélectivement dans ce syndrome dû au déplacement rostrocaudal de la moelle épiniere par fixation caudale. Nos observations cliniques sont en accord avec les données expérimentales indiquant une sensibilité différente de la substance grise et de la substance blanche à retirement progressif.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue 4 , November 1994 , pp. 325 - 330
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

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