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Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Subcortical somatosensory evoked potentials after posterior tibial nerve stimulation in children
Rainer Boor1, Ling Li, Barbara Goebel
1Department of Pediatric Neurology of the University Children's Hospital, Mainz, Germany. r.boor@drk-sutz.de
Insights
This study provides normative somatosensory evoked potential (SEP) data for children and adults, establishing reference values for posterior tibial nerve (PTN) stimulation. These SEP findings aid in assessing neurological pathways in pediatric and intraoperative settings.
Area of Science:
- Neuroscience
- Clinical Electrophysiology
Background:
- Somatosensory evoked potentials (SEPs) are crucial for evaluating the integrity of the somatosensory nervous system.
- Establishing normative SEP data across different age groups is essential for accurate clinical interpretation.
Purpose of the Study:
- To establish normative data for posterior tibial nerve somatosensory evoked potentials (PTN-SEPs) in a pediatric and adult population.
- To analyze age-related changes in SEP latencies and conduction times.
- To highlight the utility of subcortical PTN-SEPs in specific clinical scenarios.
Main Methods:
- Collected SEP data from 89 children and 18 adults (0.4-29.2 years) following posterior tibial nerve stimulation.
- Recorded near-field potentials from peripheral nerve to cortex and far-field potentials from scalp electrodes.
- Analyzed latencies, amplitudes, and interpeak latencies (e.g., N8-N22, N22-P40).
Main Results:
- N8 and P40 potentials were consistently observed.
- Age-related increases in latencies and decreases in central conduction times (up to age 10) were noted.
- Significant variability in amplitudes across age groups was found.
Conclusions:
- Normative PTN-SEP data, including interpeak latencies, are presented for clinical application.
- Subcortical PTN-SEPs offer valuable diagnostic information, especially in sedated/anesthetized patients or those with developmental delays.
- These findings support the use of PTN-SEPs for assessing specific components of the somatosensory pathway.
Abstract:
We report our normative data of somatosensory evoked potentials (SEP) after posterior tibial nerve (PTN) stimulation from a group of 89 children and 18 adults, 0.4-29.2 years of age. We recorded near-field potentials from the peripheral nerve, the cauda equina, the lumbar spinal cord and the somatosensory cortex. Far-field potentials were recorded from the scalp electrodes with a reference at the ipsilateral ear. N8 (peripheral nerve) and P40 (cortex) were present in all children but one. N20 (cauda equina) and N22 (lumbar spinal cord) were recorded in 94 and 106 subjects, respectively. P30 and N33 (both waveforms probably generated in the brainstem) were recorded in 103 and 101 subjects, respectively. Latencies increased with age, while central conduction times including the cortical component, decreased with age (up to about age 10 years). The amplitudes of all components were very variable in each age group. We report our normative data of the interpeak latencies N8-N22 (peripheral conduction time), N22-P30 (spinal conduction time), N22-P40 (central conduction time) and P30-P40 (intracranial conduction time). These interpeak latencies should be useful to assess particular parts of the pathway. The subcortical PTN-SEPs might be of particular interest in young or retarded children and during intraoperative monitoring, when the cortical peaks are influenced by sedation and sleep, or by anesthesia.
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