Conus medullaris stroke. Does F wave predict return of ambulation?

Area of Science:

• Neuroscience
• Neurology
• Clinical Electrophysiology

Background:

• F waves, a neurophysiological marker, are typically absent during spinal shock following traumatic spinal cord injury.
• The prognostic value of F waves after conus medullaris infarct, a specific type of spinal cord injury, remains largely undescribed.

Observation:

• A middle-aged male patient with conus medullaris infarct presented with absent tibial and peroneal F waves on day 4 post-injury.
• The left tibial F wave reappeared by day 18, with all F waves returning by day 56, despite the patient remaining wheelchair-bound.
• The patient regained ambulation independently by day 105.

Findings:

• The initial absence and subsequent reappearance of F waves were documented in a patient with conus medullaris infarct.
• The timing of F wave recovery correlated with the patient's motor function recovery, specifically the return of ambulation.

Implications:

• The reappearance of F waves after conus medullaris infarct may serve as a positive prognostic indicator for regaining the ability to walk.
• This observation suggests F wave analysis could be a valuable tool in assessing recovery potential in spinal cord injury patients.
• Further research is warranted to validate these findings and explore the clinical utility of F waves in predicting neurological recovery.