Electrophysiological signs of arteriovenous malformations of the spinal cord

A characteristic pattern of electrophysiological changes was found in 24 patients with confirmed spinal cord arteriovenous malformations (AVMs). The AVMs were limited to the thoracic cord in seven, involved the conus and the cauda equina in 10, and involved all levels in six. Of the patients, 88% had at least one definite electrophysiological abnormality: nerve conduction studies showed abnormal results in 43% (10 of 23), needle electromyography in 77% (17 of 22), and tibial somatosensory evoked potentials in 88% (7 of 8). The pattern of involvement was of scattered, multiple, bilateral thoracolumbosacral radiculopathies, consistent with axonal or neuronal destruction, associated with paraspinal fibrillations or abnormal activation of motor unit potentials. Electrophysiological abnormalities were seen in most patients with lower motor neuron clinical deficit. These abnormalities depended on the caudal extension of the AVM, on an arterial supply at T-10 or below, and on the duration of symptoms. In addition to the expected abnormalities in the distribution of the AVM location, four patients had electrical changes at a distance, which may have been due to venous stasis.