Variability of tibial nerve early cortical potentials in normal subjects

The aim of the study was to calculate and test the variability of several tibial nerve SEP parameters, particularly scalp amplitude distribution, with a view to obtaining more reliable clinico-electrophysiological correlations. The parameters were evaluated in 20 healthy subjects using a simple, easily reproducible recording method. The absolute latency of the P40 wave was greater than that of the N37 wave, except in two cases. Paradoxical lateralization was present in all subjects. On the basis of the scalp amplitude distribution of the ipsi- and contralateral potentials, three distinct groups were identified: a) dominance of ipsilateral P40, 29 sides; b) dominance of P37, 15 sides; and c) equivalent amplitude of P37 and ipsilateral P40, 5 sides. The individual amplitude values of these potentials were plotted on a normogram. The results suggest that (i) the absence of one or more early cortical SEPs may be considered abnormal; (ii) when SEP scalp lateralization is present, it may be useful to compare the amplitude distribution of the individual components in normal and pathological populations; and (iii) for this purpose, lateralized potentials are more reliable owing to their lower degree of amplitude dispersion.