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Updated: Jun 13, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Magnetic resonance imaging and motor-evoked potentials in spinal cord infarction: report of two cases
Raffaele Nardone1, Jürgen Bergmann, Martin Kronbichler
1Department of Neurology and Neuroscience Institute, Christian Doppler Clinic, Paracelsus Private Medical University, Salzburg, Austria. raffaele.nardone@asbmeran-o.it
Abstract:
Because in the early phases of spinal cord ischemia magnetic resonance imaging (MRI) can be normal, its clinical diagnosis is often difficult. We aimed to explore if motor-evoked potentials (MEPs) recordings may contribute to earlier diagnosis of spinal cord stroke. The clinical, MRI, and MEP findings in one case each of cervical and lumbar spinal cord infarction were reported. Spinal MRI at admission was unremarkable in both patients. At this time, MEPs were abnormal in both patients, to the upper and lower limbs in the first patient, exclusively to the lower limbs in the second. Follow-up MRI examinations documented an infarction in the territory of the anterior spinal artery and of the Adamkiewicz artery, respectively. MEP study can be useful in demonstrating spinal cord involvement also when radiological evidence for spinal cord damage is absent or equivocal. Early diagnosis may allow earlier intervention and contribute to improved patient management.
Insights
Motor-evoked potentials (MEPs) aid early spinal cord stroke diagnosis when MRI is normal. This neurophysiological test helps identify spinal cord damage before imaging confirms it, improving patient outcomes.
Area of Science:
- Neurology
- Neurophysiology
- Diagnostic Imaging
Background:
- Spinal cord ischemia diagnosis is challenging due to normal early MRI findings.
- Early detection is crucial for timely intervention and better patient management.
Observation:
- Two cases of spinal cord infarction (cervical and lumbar) were analyzed.
- Initial spinal MRI scans were unremarkable in both patients.
- Motor-evoked potentials (MEPs) were abnormal in both patients upon admission.
Findings:
- Abnormal MEPs indicated spinal cord involvement before definitive MRI evidence.
- Follow-up MRIs confirmed infarction in the anterior spinal artery and Adamkiewicz artery territories.
- MEP recordings demonstrated utility in detecting spinal cord damage when imaging is equivocal.
Implications:
- Motor-evoked potentials can serve as an early diagnostic tool for spinal cord stroke.
- Integrating MEPs into diagnostic protocols may improve patient management and outcomes.
- This approach highlights the value of neurophysiological testing in acute neurological conditions.
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