Evoked potential abnormalities in postoperative patients with biliary atresia

Area of Science:

• Neurology
• Gastroenterology
• Pediatric Surgery

Background:

• Biliary atresia can lead to malabsorption of fat-soluble vitamins, particularly vitamin E.
• Vitamin E deficiency is associated with progressive neuropathy.
• Neurologic complications in biliary atresia patients require thorough investigation.

Purpose of the Study:

• To assess for neurologic dysfunction in patients with biliary atresia.
• To evaluate the relationship between fat-soluble vitamin status and neurologic function.
• To investigate somatosensory evoked potentials (SEPs) in the lower extremities postoperatively.

Main Methods:

• Somatosensory evoked potentials (SEPs) were recorded from the lower extremities in 15 biliary atresia patients and 45 controls.
• Cerebral evoked potentials were recorded in all patients.
• Serum levels of vitamins E, D, and A were measured.

Main Results:

• Spinal evoked potentials could not be recorded in 5 patients over 8 years old with long-standing icterus.
• The remaining 10 patients showed spinal evoked potentials, but with significantly lower mean neural conduction velocity at the cauda equina compared to controls (42.0 m/s vs 52.3 m/s).
• Serum vitamin E, D, and A levels were mostly within the normal range.

Conclusions:

• Patients with biliary atresia, even with normal vitamin E levels, are at risk for neural disturbances.
• Long-term monitoring for neurologic dysfunction is essential in biliary atresia survivors.
• Somatosensory evoked potentials are valuable tools for detecting subclinical neuropathy in this population.