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Motor evoked potentials and compound muscle action potentials as prognostic tools for neonates with spina bifida
Inge Cuppen1, Niels Geerdink, Jan J Rotteveel
1Radboud University Nijmegen Medical Centre, Department of Paediatric Neurology, 820, PO Box 9101, Nijmegen 6500 HB, The Netherlands. I.Cuppen@umcutrecht.nl
Insights
Motor evoked potentials (MEPs) and compound muscle action potentials (CMAPs) can predict motor and sensory impairments in infants with spina bifida, aiding in early prognosis.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Clinical Electrophysiology
Background:
- Spina bifida is a complex congenital condition affecting motor and sensory function.
- Accurate prognostic tools are crucial for managing pediatric neurological disorders.
- Early neurophysiological assessments can offer insights into long-term outcomes.
Purpose of the Study:
- To evaluate the prognostic value of motor evoked potentials (MEPs) and compound muscle action potentials (CMAPs) in neonates with spina bifida.
- To compare the predictive accuracy of neurophysiological tests with clinical neurological examinations.
- To establish MEPs and CMAPs as reliable indicators of neurological impairment in spina bifida.
Main Methods:
- Prospective study of 36 neonates with spina bifida, followed for 2 years.
- Neonatal assessment included lumbar MEPs and CMAPs from lower limb muscles.
- Clinical outcomes were assessed at 2 years using Muscle Function Classes (MFCs) and ambulation status.
Main Results:
- Larger MEP and CMAP areas in neonatal assessments correlated with better muscle function at 2 years.
- These neurophysiological parameters were associated with lower levels of neonatal motor and sensory impairment.
- MEPs and CMAPs demonstrated prognostic value for lower limb function.
Conclusions:
- Neonatal motor evoked potentials (MEPs) and compound muscle action potentials (CMAPs) are valuable prognostic indicators for spina bifida.
- These electrophysiological measures predict clinical neurological outcomes, including muscle function and ambulation.
- MEPs and CMAPs of the gastrocnemius and tibialis anterior muscles offer significant prognostic information.
Unlabelled:
MEPs and CMAPs as prognostic tools for spina bifida.
Aim:
The aim of this prospective study was to determine the prognostic value of neurophysiological investigations compared to clinical neurological examination in infants with spina bifida.
Methods:
Thirty-six neonates born with spina bifida between 2002 and 2007 were evaluated and followed for 2 years. Lumbar motor evoked potentials (MEPs) and compound muscle action potentials (CMAPs) were obtained at the median age of 2 days old before surgical closure of the spinal anomaly. MEPs were recorded from the quadriceps femoris, tibialis anterior, and gastrocnemius muscles and CMAPs from the latter two muscles. Areas under the curve and latencies of the MEPs and CMAPs were measured. Clinical neurological outcome at the age of 2 years was described using Muscle Function Classes (MFCs) and ambulation status.
Results:
The areas under the curve of MEPs and CMAPs in the legs were associated with lower neonatal levels of motor and sensory impairment. Better muscle function class of the lower limbs at 2 years of age was associated with larger MEP and CMAP areas of the gastrocnemius and tibialis anterior muscles at neonatal age.
Discussion:
MEPs and CMAPs of the gastrocnemius and tibialis anterior muscles are of prognostic value for clinical neurological outcome in neonates born with spina bifida.
