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Published on: January 29, 2014
Somatosensory evoked potentials in Arnold-Chiari malformation
Rainer Boor1, Manfred Schwarz, Barbara Goebel
1Department of Pediatric Neurology, University Children's Hospital, Johannes Gutenberg University, Langenbeckstrasse 1, D-55101 Mainz, Germany. boor@kinder.klinik.uni-mainz.de
Brain & Development
|March 24, 2004
Summary
Somatosensory evoked potentials (SEPs) can objectively assess brainstem function in patients with Arnold-Chiari (AC) malformation. Abnormal SEPs effectively identify symptomatic AC malformation, particularly in children over 4 years old.
Area of Science:
- Neuroscience
- Clinical Neurology
- Pediatric Neurosurgery
Background:
- Arnold-Chiari (AC) malformation is common in myelomeningocele patients, with 20% developing brainstem dysfunction.
- Current management of symptomatic AC malformation lacks objective assessment tools for brainstem function.
Purpose of the Study:
- To evaluate the utility of somatosensory evoked potentials (SEPs) in differentiating symptomatic from asymptomatic AC malformation.
- To determine if SEPs can provide an objective measure of brainstem function in AC malformation patients.
Main Methods:
- SEPs were recorded in 52 patients (8 months–20 years) with AC malformation.
- Subcortical (P13, P14, N18) and cortical (N20) SEP components were analyzed.
- Patients were assessed for clinical signs of brainstem dysfunction.
Main Results:
- Abnormal SEPs were found in 14 symptomatic patients (sensitivity 0.7, specificity 0.9).
- SEP utility was higher in patients aged 4 years and older (sensitivity 0.9, specificity 0.9).
- Abnormalities indicate brainstem or upper cervical cord dysfunction.
Conclusions:
- SEPs offer a valuable, objective method for assessing brainstem function in AC malformation.
- SEPs are particularly useful for evaluating symptomatic AC malformation in older children and assessing late-onset dysfunction.
