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Published on: August 18, 2011
Spinally elicited peripheral nerve responses are sensory rather than motor
J R Toleikis1, J P Skelly, A O Carlvin
1Hughston Sports Medicine Hospital, Columbus, USA. toleikis@mindspring.com
Summary
Spinally elicited peripheral nerve responses, neurogenic motor evoked potentials (NMEPs), are primarily sensory, not motor. These responses share neural pathways with somatosensory evoked potentials (SEPs).
Area of Science:
- Neurophysiology
- Surgical Monitoring
Background:
- Neurogenic motor evoked potentials (NMEPs) are used to assess spinal cord motor function during surgery.
- Emerging evidence suggests NMEPs may be predominantly sensory rather than motor in origin.
Purpose of the Study:
- To investigate the neurophysiological basis of spinally elicited peripheral nerve responses.
- To determine whether these responses are primarily motor or sensory in nature using the collision technique.
Main Methods:
- Collision studies were conducted in 7 surgical patients.
- Ascending sensory (AS) and motor (AM) volleys were elicited via posterior tibial nerve stimulation.
- Descending sensory (DS) and motor (DM) volleys were produced by high cervical spinal stimulation.
- Inter-stimulus delays were manipulated to induce volleys collision within the spinal cord.
- Remaining DS and DM activity was recorded from posterior tibial nerves.
Main Results:
- Peripheral descending volleys were absent with inter-stimulus delays of 18 ms or less.
- These results were consistent across all studied patients.
Conclusions:
- Spinally elicited peripheral nerve responses are primarily sensory.
- These responses utilize the same neural pathways as somatosensory evoked potentials (SEPs).
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