Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study
Objective: The utility of Dermatomal Somatosensory Evoked Potentials (DSEPs) in the diagnostic workup of suspected cervical monoradiculopathy has been limited by significant overlap between measurements obtained from affected versus unaffected roots. In a case-control study, we explored whether, und...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | Clinical Neurophysiology Practice |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2467981X16300178 |
| _version_ | 1819088465217716224 |
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| author | Christos Moschovos Apostolia Ghika Andreas Kyrozis |
| author_facet | Christos Moschovos Apostolia Ghika Andreas Kyrozis |
| author_sort | Christos Moschovos |
| collection | DOAJ |
| description | Objective: The utility of Dermatomal Somatosensory Evoked Potentials (DSEPs) in the diagnostic workup of suspected cervical monoradiculopathy has been limited by significant overlap between measurements obtained from affected versus unaffected roots. In a case-control study, we explored whether, under certain conditions, asymmetry in DSEP parameters may offer significant help in the diagnosis of monoradiculopathy. Methods: DSEPs were obtained bilaterally from patients with persistent (age range 33–55, n = 10) or intermittent (age range 31–55, n = 7) unilateral sensory symptoms of less than one month duration due to MRI-confirmed cervical monoradiculopathy. DSEPs were also obtained bilaterally from aged-matched asymptomatic volunteers (age range 31–54, n = 8) and older asymptomatic volunteers (age range 57–77, n = 8). Amplitude and latency of the P/N13′ potential (negative peak at 13 ms) were measured. Results: In all ten patients with persistent symptoms, the P/N13′ amplitude ratio, defined as P/N13′ amplitude on the symptomatic side divided by P/N13′ amplitude on the contralateral asymptomatic side, ranged between 0.0 and 0.50 (unilateral suppression). In all seven patients with intermittent symptoms, P/N13′ amplitude ratios ranged between 0.60 and 1.00. In all age-matched asymptomatic controls, P/N13′ amplitude ratio (side with lower divided by side with higher amplitude) was always at least 0.80. Among older asymptomatic subjects, DSEPs had inconsistent characteristics. Conclusions: Cervical monoradiculopathy with persistent numbness in young patients (aged up to 55 years) is very strongly associated with unilateral suppression of P/N13′ DSEP amplitude. No significant asymmetry is observed in cases of monoradiculopathy with intermittent numbness. Significance: In young patients with unilateral upper extremity persistent sensory complaints, DSEP amplitude asymmetry, as quantified by the P/N13′ ratio, may offer significant help in the diagnosis of monoradiculopathy. Keywords: Dermatomal, DSEP, Evoked potential, P/N13′, Radiculopathy, Somatosensory |
| first_indexed | 2024-12-21T21:52:28Z |
| format | Article |
| id | doaj.art-9bc3bcf565cc4209ac8d715afe6302ad |
| institution | Directory Open Access Journal |
| issn | 2467-981X |
| language | English |
| last_indexed | 2024-12-21T21:52:28Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Neurophysiology Practice |
| spelling | doaj.art-9bc3bcf565cc4209ac8d715afe6302ad2022-12-21T18:49:04ZengElsevierClinical Neurophysiology Practice2467-981X2017-01-01217Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control studyChristos Moschovos0Apostolia Ghika1Andreas Kyrozis2Neurophysiology Unit, Iatropolis Medical Group, Athens, Greece1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Greece1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Greece; Corresponding author.Objective: The utility of Dermatomal Somatosensory Evoked Potentials (DSEPs) in the diagnostic workup of suspected cervical monoradiculopathy has been limited by significant overlap between measurements obtained from affected versus unaffected roots. In a case-control study, we explored whether, under certain conditions, asymmetry in DSEP parameters may offer significant help in the diagnosis of monoradiculopathy. Methods: DSEPs were obtained bilaterally from patients with persistent (age range 33–55, n = 10) or intermittent (age range 31–55, n = 7) unilateral sensory symptoms of less than one month duration due to MRI-confirmed cervical monoradiculopathy. DSEPs were also obtained bilaterally from aged-matched asymptomatic volunteers (age range 31–54, n = 8) and older asymptomatic volunteers (age range 57–77, n = 8). Amplitude and latency of the P/N13′ potential (negative peak at 13 ms) were measured. Results: In all ten patients with persistent symptoms, the P/N13′ amplitude ratio, defined as P/N13′ amplitude on the symptomatic side divided by P/N13′ amplitude on the contralateral asymptomatic side, ranged between 0.0 and 0.50 (unilateral suppression). In all seven patients with intermittent symptoms, P/N13′ amplitude ratios ranged between 0.60 and 1.00. In all age-matched asymptomatic controls, P/N13′ amplitude ratio (side with lower divided by side with higher amplitude) was always at least 0.80. Among older asymptomatic subjects, DSEPs had inconsistent characteristics. Conclusions: Cervical monoradiculopathy with persistent numbness in young patients (aged up to 55 years) is very strongly associated with unilateral suppression of P/N13′ DSEP amplitude. No significant asymmetry is observed in cases of monoradiculopathy with intermittent numbness. Significance: In young patients with unilateral upper extremity persistent sensory complaints, DSEP amplitude asymmetry, as quantified by the P/N13′ ratio, may offer significant help in the diagnosis of monoradiculopathy. Keywords: Dermatomal, DSEP, Evoked potential, P/N13′, Radiculopathy, Somatosensoryhttp://www.sciencedirect.com/science/article/pii/S2467981X16300178 |
| spellingShingle | Christos Moschovos Apostolia Ghika Andreas Kyrozis Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study Clinical Neurophysiology Practice |
| title | Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study |
| title_full | Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study |
| title_fullStr | Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study |
| title_full_unstemmed | Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study |
| title_short | Unilateral suppression of P/N13′ potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy. A case-control study |
| title_sort | unilateral suppression of p n13 potential amplitude in young patients with persistent numbness due to cervical monoradiculopathy a case control study |
| url | http://www.sciencedirect.com/science/article/pii/S2467981X16300178 |
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