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Subcortical somatosensory evoked potentials after median nerve stimulation in children
1University Children's Hospital, Johannes-Gutenberg University, Mainz, Germany.
Insights
This study provides normative data for subcortical somatosensory evoked potentials (SEPs) in children and adults. These median nerve SEPs offer reliable insights into the somatosensory pathway and are valuable for detecting cervical cord lesions.
Area of Science:
- Neuroscience
- Clinical Electrophysiology
Background:
- Somatosensory evoked potentials (SEPs) are crucial for assessing the integrity of the somatosensory nervous system.
- Establishing normative data in pediatric and adult populations is essential for accurate clinical interpretation.
Purpose of the Study:
- To establish normative data for subcortical median nerve SEPs in children (4-15 years) and young adults (18-29 years).
- To evaluate the utility of subcortical SEPs in diagnosing lesions of the upper cervical cord and cervicomedullary junction.
Main Methods:
- Near-field potentials were recorded from the brachial plexus, cervical cord, and somatosensory cortex.
- Far-field potentials (P13, P14, N18) were recorded from scalp electrodes using specific reference techniques.
- Standard SEP components (N9, N13a, P13, N18, N20) were analyzed across age groups.
Main Results:
- Specific SEP components (N9, N13a, P13, N18, N20) were consistently present in all participants.
- Subtle differences in the presence of N13b and P14 were noted between children and adults.
- Median nerve SEPs demonstrated reliable waveform generation across the studied age range.
Conclusions:
- Subcortical median nerve SEPs provide reliable functional information about the upper limb somatosensory pathway.
- These SEPs are particularly valuable for detecting lesions in the upper cervical cord and cervicomedullary junction.
- Subcortical SEPs are robust during sleep, facilitating recordings in sedated infants and children.
Abstract:
We report our normative data of subcortical somatosensory evoked potentials (SEPs) after median nerve stimulation from a group of 55 children 4-15 years of age and 18 young adults 18-29 years of age. We recorded near-field potentials from the brachial plexus, the cervical cord and the somatosensory cortex. The far-field potentials P13, P14 and N18 from the brainstem were recorded from the scalp electrodes, when a non-cephalic reference at the contralateral Erb's point or an ear reference was used. The N9 (brachial plexus), N13a (dorsal horn), P13 (caudal medulla oblongata), N18 (medulla oblongata) and N20 (somatosensory cortex) were present in all subjects. The N13b (dorsal column near the foramen magnum or cuneate nucleus) was observed in all children and in 16 adults, P14 (medial lemniscus) in 52 children and 17 adults. The median nerve SEPs provide reliable information about the function of the somatosensory pathway from the upper limb. The subcortical median nerve SEPs should be particularly useful to detect lesions of the upper cervical cord and the cervicomedullary junction. The subcortical SEPs remain unchanged during sleep and facilitate reliable SEP recordings, when sedation is necessary in infants and children.