The clinical role of somatosensory evoked potential studies: A critical appraisal

Abstract

The clinical utility and limitations of somatosensory evoked potential (SEP) studies are reviewed. Somatosensory evoked potentials may help to identify a lesion in the sensory pathways, but do not indicate its nature. In multiple sclerosis subjects, the SEP findings may help to establish that there is a multiplicity of lesions, but multimodality evoked potential abnormalities may occur in other disorders. Somatosensory evoked potential abnormalities do not reflect either the severity or the prognosis of cervical spondylosis and do not reliably permit early recognition of the totality of traumatic cord lesions, while the role of SEPs in monitoring cord function intraoperatively awaits definition. Somatosensory evoked potentials do not reliably indicate the individual prognosis after severe head injury, and discrepancies in published findings suggest that their use in the evaluation of brain death is premature. In hereditary spinocerebellar degenerations, SEP abnormalities may reflect central or peripheral pathology. Somatosensory evoked potentials can be used to determine conduction velocity in peripheral nerves and to identify inaccessible proximal lesions of these nerves, but the findings may lead to misleading conclusions about brachial plexus lesions, especially if pre- and postganglionic lesions coexist.

Reliability, validity and clinical usability of a robotic assessment of finger proprioception in persons with multiple sclerosis

“…This result is in agreement with literature, as it has been shown that upper limb SSEPs abnormalities occur in about half of pwMS who have no sensory symptoms (Chiappa and Ropper, 1982), and the overall incidence of SSEPs abnormalities has been reported to be up to 80% (Walsh, 2005). Indeed, SSEPs can capture demyelination occurring within the central fibres of the dorsal column or in the brain, which is not necessarily linked to somatosensory symptoms (Aminoff, 1984). Hence SSEPs can be seen as a measure describing the overall integrity of the sensory system, rather than a specific somatosensory deficit.…”

“…Increased SSEPs latency is common in MS due to demyelination within the central fibres of the dorsal column and has been shown to coincide with sensory symptoms (Walsh, 2005). However, the use of SSEPs in regular clinical practice has been questioned, since their recording is time consuming, labour intensive and requires trained personnel (Aminoff, 1984). Therefore, novel assessment approaches are needed, which could allow to quantitatively measure proprioception in a clinically meaningful and applicable way.…”

Hypoglycemic sensorimotor polyneuropathy associated with insulinoma

“…Somatosensory evoked median and tibial potentials showed increased right N20 and bilateral P40 latencies. 2,13 These findings accorded with an axonal sensorimotor polyneuropathy with the main focus on the upper limbs.…”

Spinal Cord Infarction: A Single Center Experience and the Usefulness of Evoked Potential as an Early Diagnostic Tool

“…However, from an anatomical perspective, the ascending sensory pathway of the spinal cord is adjacent to the pyramidal tracts. Moreover, other studies have demonstrated that SEP is correlated with motor outcomes related to ischemic injury (35). This is also supported by the distribution of the vascular supply of the spinal cord.…”