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Short latency somatosensory evoked potentials in brain-dead patients using restricted low cut filter setting
C Machado1, P Valdès, O García
1Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba.
Abstract:
This paper describes the SSEP patterns in BD when using restricted filter bandpass setting, with special emphasis on the dissociation of some SSEP components when cephalic and non-cephalic references are used. A characteristic SSEP pattern was found: absence of N20 and later responses in the Cc'-Fpz lead and preservation of all or some of the so-called subcortical components in the rest of the derivations. We noted an interesting dissociation in which some SSEP components were not recorded in the scalp-non cephalic derivations, but they were still present in the neck-cephalic and spine channels, with inverse polarity. We selected a restricted bandpass for the scalp-non cephalic, the neck-cephalic and the spine derivations, and we found this dissociation not only for P13-N13 and P14-N14, but for Nm-Pm' and Pm-Nm' components. It is likely that components Nm-Pm' and Pm-Nm' are "far-field potentials" that appear when the slow wave N18 is filtered out by the use of a restricted low filter setting. Our data further suggest that all components after N14-P14, recorded with restricted filter bandpass also recognize two distinct generator sources. Rostral generators are located probably in the brainstem and/or thalamus, but at least a significant part of these SSEP components are generated at the very lower part of the medulla oblongata (dorsal column nuclei) and/or at the upper cervical spine.(ABSTRACT TRUNCATED AT 250 WORDS)