Download PDF
Semin Neurol 2002; 22(2): 197-204
DOI: 10.1055/s-2002-36543
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Electrophysiological Evaluation of Root and Spinal Cord Disease

Michael J. Aminoff
  • Department of Neurology, University of California San Francisco, San Francisco, California
Further Information

Publication History

Publication Date:
13 January 2003 (online)

    Permissions and Reprints

ABSTRACT

The electrophysiological evaluation of root or spinal cord disease is complementary to neuroimaging studies, providing information about functional rather than anatomical integrity and information that is important for diagnostic and prognostic purposes. The electrophysiological findings help to localize a lesion but are not pathognomonic of specific diseases. The findings may also provide insight into underlying physiological mechanisms that have been disrupted. A number of different electrophysiological techniques are now in widespread use. Each of these techniques provides different information and thus has distinct utility and limitations. The optimal evaluation of patients with root or spinal cord disease requires an understanding of how these techniques complement each other and depends on the individual clinical problem for which electrophysiological assessment is requested.

KEYWORDS

Myelopathy - radiculopathy - electromyography - evoked potentials - late responses

REFERENCES

  • 1 Jensen M C, Brant-Zawadski M N, Obuchowski N, Medic M T, Malkasian D, Ross J S. Magnetic resonance imaging of the lumbar spine in people without back pain.  N Engl J Med . 1994;  331 69-73
    CrossrefPubMedGoogle Scholar
  • 2 Wilbourn A J, Aminoff M J. The electrodiagnostic examination in patients with radiculopathies.  Muscle Nerve . 1998;  21 1612-1631
    PubMedGoogle Scholar
  • 3 Aminoff M J. Electromyography in Clinical Practice.  3rd ed. New York: Churchill Livingstone 1998
    Google Scholar
  • 4 Aminoff M J, Goodin D S, Parry G J, Barbaro N M, Weinstein P R, Rosenblum M L. Electrophysiological evaluation of lumbosacral radiculopathies: electromyography, late responses and somatosensory evoked potentials.  Neurology . 1985;  35 1514-1518
    PubMedGoogle Scholar
  • 5 Eisen A. Electrodiagnosis of radiculopathies.  Neurol Clin . 1985;  3 495-510
    PubMedGoogle Scholar
  • 6 Wilbourn A J, Aminoff M J. Radiculopathies. In: Brown WF, Bolton CF, eds. Clinical Electromyography 2nd ed. Boston: Butterworth-Heinemann 1993: 177-209
    Google Scholar
  • 7 Wilbourn A J. The value and limitations of electromyographic examination in the diagnosis of lumbosacral radiculopathy. In: Hardy RW, ed. Lumbar Disc Disease New York: Raven Press 1982: 65-109
    Google Scholar
  • 8 Wilbourn A J, Aminoff M J. The electrophysiological examination in patients with radiculopathies.  Muscle Nerve . 1988;  11 1099-1114
    CrossrefPubMedGoogle Scholar
  • 9 Benecke R, Conrad B. The distal sensory nerve action potential as a diagnostic tool for the differentiation of lesions in dorsal roots and peripheral nerves.  J Neurol . 1980;  223 231-239
    CrossrefPubMedGoogle Scholar
  • 10 Brandstater M E, Fullerton M. Sensory nerve conduction studies in cervical root lesions.  Can J Neurol Sci . 1983;  10 152
    PubMedGoogle Scholar
  • 11 Tackman W, Rader E W. Observations on the application of electrophysiological methods in the diagnosis of cervical root compressions.  Eur Neurol . 1983;  22 397-404
    PubMedGoogle Scholar
  • 12 Scelsa S, Herskovitz S, Berger A R. The diagnostic utility of F-waves in L5/S1 radiculopathies.  Muscle Nerve . 1995;  18 1496-1497
    PubMedGoogle Scholar
  • 13 Nishida T, Kompoliti A, Janssen I, Levin K F. H reflex in S-1 radiculopathy: latency versus amplitude controversy revisited.  Muscle Nerve . 1996;  19 915-917
    PubMedGoogle Scholar
  • 14 Aminoff M J, Eisen A. Somatosensory evoked potentials. In: Aminoff MJ, ed. Electrodiagnosis in Clinical Neurology 3rd ed. New York: Churchill Livingstone 1992: 571-603
    Google Scholar
  • 15 Aminoff M J, Eisen A. Somatosensory evoked potentials.  Muscle Nerve . 1998;  21 277-290
    PubMedGoogle Scholar
  • 16 Eisen A, Hoirch M, Moll A. Evaluation of radiculopathies by segmental stimulation and somatosensory evoked potentials.  Can J Neurol Sci . 1983;  10 178-182
    PubMedGoogle Scholar
  • 17 Perlik S, Fisher M A, Patel D V, Slack C. On the usefulness of somatosensory evoked responses for the evaluation of lower back pain.  Arch Neurol . 1986;  43 907-913
    PubMedGoogle Scholar
  • 18 Walk D, Fisher M A, Doundoulakis S H, Hemmati M. Somatosensory evoked potentials in the evaluation of lumbosacral radiculopathy.  Neurology . 1992;  42 1197-1202
    PubMedGoogle Scholar
  • 19 Seyal M, Sandhu L S, Mack Y P. Spinal segmental somatosensory evoked potentials in lumbosacral radiculopathies.  Neurology . 1989;  39 801-805
    PubMedGoogle Scholar
  • 20 Dumitru D, Dreyfuss P. Dermatomal/segmental somatosensory evoked potential evaluation of L5/S1 unilateral/unilevel radiculopathies.  Muscle Nerve . 1996;  19 442-449
    PubMedGoogle Scholar
  • 21 Scarff T B, Dallman D E, Toleikis J R, Bunch W H. Dermatomal somatosensory evoked potentials in the diagnosis of lumbar root entrapment.  Surg Forum . 1981;  32 489-491
    PubMedGoogle Scholar
  • 22 Aminoff M J, Goodin D S, Barbaro N M, Weinstein P R, Rosenblum M L. Dermatomal somatosensory evoked potentials in unilateral lumbosacral radiculopathy.  Ann Neurol . 1985;  17 171-176
    CrossrefPubMedGoogle Scholar
  • 23 Rodriquez A A, Kanis L, Rodriquez A A, Lane D. Somatosensory evoked potentials from dermatomal stimulation as an indicator of L5 and S1 radiculopathy.  Arch Phys Med Rehabil . 1987;  68 366-368
    PubMedGoogle Scholar
  • 24 Katifi H A, Sedgwick E M. Evaluation of the dermatomal somatosensory evoked potential in the diagnosis of lumbosacral root compression.  J Neurol Neurosurg Psychiatry . 1987;  50 1204-1210
    PubMedGoogle Scholar
  • 25 Aminoff M J, Goodin D S. Dermatomal somatosensory evoked potentials in lumbosacral root compression.  J Neurol Neurosurg Psychiatry . 1988;  51 740-741
    PubMedGoogle Scholar
  • 26 Berger A R, Busis N A, Logigian E L, Wierzbicka M, Shahani B T. Cervical root stimulation in the diagnosis of cervical radiculopathy.  Neurology . 1987;  37 329-332
    CrossrefPubMedGoogle Scholar
  • 27 Chang C W, Lien I N. Spinal nerve stimulation in the diagnosis of lumbosacral radiculopathy.  Am J Phys Med Rehabil . 1990;  69 318-322
    PubMedGoogle Scholar
  • 28 Chokroverty S, Picone M A, Chokroverty M. Percutaneous magnetic coil stimulation of human cervical vertebral column: site of stimulation and clinical application.  Electroencephalogr Clin Neurophysiol . 1991;  81 359-365
    CrossrefPubMedGoogle Scholar
  • 29 Chokroverty S, Sachdeo R, DiLullo J, Duvoisin R C. Magnetic stimulation in the diagnosis of lumbosacral radiculopathy.  J Neurol Neurosurg Psychiatry . 1989;  52 767-772
    PubMedGoogle Scholar
  • 30 Spielholz N I, Sell G H, Goodgold J, Rusk H A, Greens S K. Electrophysiological studies in patients with spinal cord injuries.  Arch Phys Med Rehabil . 1972;  53 558-562
    PubMedGoogle Scholar
  • 31 Taylor R G, Kewalramani L S, Fowler W M. Electromyographic findings in lower extremities of patients with high spinal cord injury.  Arch Phys Med Rehabil . 1974;  55 16-23
    PubMedGoogle Scholar
  • 32 Brandstater M E, Dinsdale S M. Electrophysiological studies in the assessment of spinal cord lesions.  Arch Phys Med Rehabil . 1976;  57 70-74
    PubMedGoogle Scholar
  • 33 Shefner J M, Tun C. Clinical neurophysiology of focal spinal cord injury.  Neurol Clin . 1991;  9 671-678
    PubMedGoogle Scholar
  • 34 Reske-Nielsen E, Harmsen A, Ovesen N. Pathological study of muscle biopsies from the legs in patients with fractures of the cervical spine. Acualités de Pathologie Neuromusculaire Paris: Expansion Scientifique 1971: 509-520
    Google Scholar
  • 35 Fisher M A. F/M ratios in polyneuropathy and spastic hyperreflexia.  Muscle Nerve . 1988;  11 217-222
    PubMedGoogle Scholar
  • 36 Dyro F M, Rossier A B. Electrodiagnostic abnormalities in 15 patients with post traumatic syringomyelia: pre- and postoperative studies.  Paraplegia . 1985;  23 233-242
    PubMedGoogle Scholar
  • 37 Cadilhac J, Georgesco M, Benezech J, Duday H, Dapres G. Potentiel évoqué cérébral somesthésique et réflexe d'Hoffmann dans les lésions médullaires aigues intérêt physiopathologique et pronostic.  Electroencephalogr Clin Neurophysiol . 1977;  43 160-167
    PubMedGoogle Scholar
  • 38 Little J W, Halar E M. H reflex changes following spinal cord injury.  Arch Phys Med Rehabil . 1985;  66 19-22
    PubMedGoogle Scholar
  • 39 Taylor S, Ashby P, Verrier M. Neurophysiological changes following traumatic spinal lesions in man.  J Neurol Neurosurg Psychiatry . 1984;  47 1102-1108
    PubMedGoogle Scholar
  • 40 Olney R K, Aminoff M J, So Y T. Clinical and electrodiagnostic features of X-linked recessive bulbospinal neuronopathy.  Neurology . 1991;  41 823-828
    PubMedGoogle Scholar
  • 41 Eisen A, Shytbel W, Murphy K, Hoirch M. Cortical magnetic stimulation in amyotrophic lateral sclerosis.  Muscle Nerve . 1990;  13 146-151
    PubMedGoogle Scholar
  • 42 Schriefer T N, Hess C W, Mills K R, Murray N MF. Central motor conduction studies in motor neurone disease using magnetic brain stimulation.  Electroencephalogr Clin Neurophysiol . 1989;  74 431-437
    PubMedGoogle Scholar
  • 43 Matheson J K, Harrington H, Hallett M. Abnormalities of somatosensory, visual, and brain stem auditory evoked potentials in amyotrophic lateral sclerosis.  Muscle Nerve . 1983;  6 529
    PubMedGoogle Scholar
  • 44 Cosi V, Poloni M, Mazzini L, Callieco R. Somatosensory evoked potentials in amyotrophic lateral sclerosis.  J Neurol Neurosurg Psychiatry . 1984;  47 857-861
    PubMedGoogle Scholar
  • 45 Radtke R A, Erwin A, Erwin C W. Abnormal sensory evoked potentials in amyotrophic lateral sclerosis.  Neurology . 1986;  36 796-801
    PubMedGoogle Scholar
  • 46 Pinelli P, Buchthal F. Duration, amplitude and shape of muscle action potentials in poliomyelitis.  Electroencephalogr Clin Neurophysiol . 1951;  3 497-504
    PubMedGoogle Scholar
  • 47 So Y T, Olney R K. Acute paralytic poliomyelitis.  Muscle Nerve . 1991;  14 1159-1164
    PubMedGoogle Scholar
  • 48 Hayward M, Seaton D. Late sequelae of paralytic poliomyelitis: a clinical and electromyographic study.  J Neurol Neurosurg Psychiatry . 1979;  42 117-122
    PubMedGoogle Scholar
  • 49 Britton T C, Meyer B U, Benecke R. Variability of cortically evoked motor responses in multiple sclerosis.  Electroencephalogr Clin Neurophysiol . 1991;  81 186-194
    PubMedGoogle Scholar
  • 50 Cowan J MA, Rothwell J C, Dick J PR, Thompson P D, Day B L, Marsden C D. Abnormalities in central motor pathway conduction in multiple sclerosis.  Lancet . 1984;  2 304-307
    PubMedGoogle Scholar
  • 51 Mills K R, Murray N MF. Corticospinal tract conduction time in multiple sclerosis.  Ann Neurol . 1985;  18 601-605
    CrossrefPubMedGoogle Scholar
  • 52 Hess C W, Mills K R, Murray N MF, Schriefer T N. Magnetic brain stimulation: central motor conduction studies in multiple sclerosis.  Ann Neurol . 1987;  22 744-752
    CrossrefPubMedGoogle Scholar
  • 53 Ingram D A, Thompson A J, Swash M. Central motor conduction in multiple sclerosis: evaluation of abnormalities revealed by transcutaneous magnetic stimulation of the brain.  J Neurol Neurosurg Psychiatry . 1988;  51 487-494
    PubMedGoogle Scholar
  • 54 Eisen A A, Shtybel W. Clinical experience with transcranial magnetic stimulation.  Muscle Nerve . 1990;  13 995-1011
    CrossrefPubMedGoogle Scholar
      >