Clinical application of spinal cord action potential measurement

Tsuyama, Naoichi; Tsuzuki, Nobuyoshi; Kurokawa, Takahide; Imai, T.

doi:10.1007/bf00266001

Cited by 62 publications

(16 citation statements)

References 7 publications

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“…The degradation of the major initial spike in conductive SCEP reflects, in part at least, blockage of spinal motor neuron conduction because the major spike of conductive SCEP is believed to originate mainly from the lateral column and partly from the dorsal and anterior columns. 17,20,21 Our study also demonstrated the dosedependent suppression effect of desflurane on D-SSEP and M-SSEP. The characteristics of the origin of these two SSEPs are similar: the synaptically induced depolarization of neurons in the spinal cord.…”

Section: Mechanism Of the Suppression Effect Of Desfluranesupporting

confidence: 74%

Effects of Desflurane on Spinal Somatosensory-Evoked Potentials and Conductive Spinal Cord Evoked Potential

Jou

Chern

Chen

et al. 2003

Spine

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The concentration of desflurane alters the amplitude of somatosensory-evoked potential and spinal cord evoked potential, and, to a lesser degree, delays the latency; spinal cord evoked potential is more liable to be suppressed than somatosensory-evoked potential. The dose-dependent suppression effect on amplitude should be considered when interpreting changes during surgery. Furthermore, the potential benefit of somatosensory-evoked potential elicited by direct major nerve stimulation should be considered because of its large amplitude and higher resistance, even with a greater concentration of volatile anesthetics.

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Section: Mechanism Of the Suppression Effect Of Desfluranesupporting

confidence: 74%

Effects of Desflurane on Spinal Somatosensory-Evoked Potentials and Conductive Spinal Cord Evoked Potential

Jou

Chern

Chen

et al. 2003

Spine

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“…[8][9][10][11] Although its value in assessing acute hypoxic states is well established, 12,13 its benefit in assessing the effect of chronic hypoxic-hypercapnic states on the nervous system was doubtful. [14][15][16][17][18][19] Cognitive event-related evoked potentials (EREPs) are long-latency potentials obtained during information processing tasks which involve attention, stimulus discrimination, memory, and related processes.…”

Section: Dovepressmentioning

confidence: 99%

Event-related evoked potentials in chronic respiratory encephalopathy

Tahan

Zaidan²,

Jones³

et al. 2010

COPD

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Background:Cognitive event-related potential (P 300 ) is an index of cognitive processing time. It was found to be prolonged in dementia, renal, and hepatic encephalopathies, but was not extensively assessed in respiratory failure. Objective: To evaluate P 300 changes in patients with respiratory failure, and especially those with mild or subclinical hypoxic-hypercapnic encephalopathy. Methods: Auditory event-related evoked potential P 300 latency was measured using an oddball paradigm in patients with respiratory failure due to any cause (partial pressure of oxygen in arterial blood (PO 2 ) should be 75 mm/Hg or less). Apart from blood gases measurement, patients underwent the Mini-Mental State Examination (MMSE). Patient performances were compared with that of matched normal control. Patients were admitted into the study from outpatient clinics and wards at King Khalid University Hospital and Sahara Hospital. Results: Thirty-four patients (12 women, 22 men) were admitted to the study. Ages ranged from 19-67 years with a mean of 46.1 years. Respiratory failure was severe or very severe in 11 patients (33%), and mild or moderate in the rest (66%). Mean value for PO 2 and partial pressure of carbon dioxide in arterial blood (PCO 2 ) were 63.7 and 45.2 mm/Hg, respectively. pH mean was 7.4 and O 2 saturation was 90.7%. P 300 latency ranged from 218 to 393 milliseconds, with a mean of 338.4 milliseconds. In comparison with control (309.9 milliseconds), there was a significant difference (P = 0.007). P 300 amplitude differences were not significant. No significant difference in MMSE was noted between mild and severe respiratory failure. Results of detailed neuropsychological assessment were clearly abnormal but were limited by the small number of tested patients. P 300 latency changes correlated significantly with age as well as severity of respiratory failure. P 300 was also significantly delayed whether hypoxia occurred with or without hypercapnia. Conclusion: Results show a significant delay of P 300 latency in patients with severe and mild respiratory failure. This was associated with subclinical encephalopathy in most patients, evidenced by a near-normal MMSE score. Apart from confirming the importance of P 300 latency measurement as a marker of respiratory encephalopathy, this study asserts the causal relationship between hypoxemia and cognitive derangement. Furthermore, it promotes the early use of oxygen therapy in a selected group of patients with mild or moderate respiratory failure, who have responsibilities which involve taking rapid critical decisions.

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“…Intraoperative monitoring of spinal cord function using spinal cord potentials (SCP) recorded with epidural catheter electrodes is thought to be reliable, as epidurally recorded ascending conducted SCP (ascending SCP) remain constant and are almost unaffected by anesthetic agents (Macon et al, 1982;Tamaki et al, 1981Tamaki et al, , 1984Tsuyama et al, 1978). In order to prevent spinal cord damage caused by manipulation of the spinal cord or spine, we have been monitoring spinal cord function during surgery using epidural recording , which permits simple and safe recording of stable ascending SCPs.…”

Section: Hitoshi Fujioka and Koki Shimojimentioning

confidence: 99%

Evoked Spinal Cord Potentials

Shimoji¹,

Willis²

2006

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PrefaceThe technique of using evoked spinal cord potentials (SCPs) has become an important clinical tool for monitoring spinal cord surgery and diagnosing spinal cord diseases. The technique is a result both of the technical development of recording evoked SCPs from the epidural space without perforation of the dura mater and of the development of medical electronics. Its use as a monitoring tool is based on continuous epidural analgesia with an epidural catheter. Since the first development of epidural recording of evoked SCPs in 1971, the technique has been applied in various institutes, particularly for monitoring during spine or spinal cord surgery and cardiovascular surgery, and recently for diagnosis of spinal cord diseases.Although the results of studies on monitoring during surgery have proved useful, more detailed neurophysiological mechanisms in the origin of each component of evoked SCPs remain to be explained in the area of diagnosis of spinal or central nervous system diseases. Further neurophysiological and neuropharmacological studies of the human spinal cord may contribute to the clinical application of recording evoked SCPs for diagnosis of spinal cord diseases.The aim of this book is to furnish a survey of the neurophysiological and neuropharmacological bases of evoked SCPs with reference to animal studies and the techniques of recording the potentials mainly from the spinal epidural space. The authors have been involved in the field from the beginning of the 1970s. Many illustrations are presented for better understanding the neurophysiological and neuropharmacological backgrounds of monitoring spinal cord functions. Case studies also are presented and discussed to provide more insight into the monitoring and diagnosis of spinal cord dysfunctions and spinal cord diseases. This book is thus appropriate even for students or those new to the fields of clinical neurophysiology, neurosurgery, neurology, orthopedics, and neuroanesthesia who are interested in monitoring spinal cord function during surgery or diagnosing spinal cord diseases. A diverse range of terminology has been used in the literature to date, sometimes leading to misinterpretation of each component in the field of evoked SCPs. To avoid such misinterpretation and to provide readers with an accurate understanding, terminology referring to basic animal studies is used, and lucid explanations are included in this volume.

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Clinical application of spinal cord action potential measurement

Cited by 62 publications

References 7 publications

Effects of Desflurane on Spinal Somatosensory-Evoked Potentials and Conductive Spinal Cord Evoked Potential

Effects of Desflurane on Spinal Somatosensory-Evoked Potentials and Conductive Spinal Cord Evoked Potential

Event-related evoked potentials in chronic respiratory encephalopathy

Evoked Spinal Cord Potentials

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