Somatosensory Evoked Potential for Detection of Subclinical Neuropathy in Egyptian Children with Acute Lymphoblastic Leukaemia

Tantawy, Azza Abdel Gawad; Hassanein, Sahar M A; Adly, Amira Abdel Moneam; Saeed, Osman; Darwish, Yasser W.; Aziz, Asif

doi:10.3923/pjbs.2010.527.536

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…First, the analyzed patient groups differed in terms of age. However, it has been shown that age is not a significant factor modulating EP [26]. Second, in our study we analyzed asymptomatic patients.…”

Section: Discussionmentioning

confidence: 96%

Clinical utility of complex assessment with evoked potentials in acute lymphoblastic leukemia survivors: comparison of various treatment protocols

et al. 2021

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Background One of the greatest success of pediatric hematology is a prominent improvement of survival in acute lymphoblastic leukemia (ALL). Therefore, special attention needs to be paid to long-term side effects of the treatment such as neurotoxicity. One of the few diagnostic methods that allow an objective assessment of sensory systems are evoked potentials (EP). Methods The analyzed group consisted of 167 ALL long-term survivors, aged 4.9–28.4 years, without auditory, visual and sensory deviations. Patients were treated with New York (NY, n = 35), previous modified Berlin-Frankfurt-Münster (pBFM, n = 47) and BFM95 (n = 85) protocols. In order to assess the impact of radiotherapy on recorded EP, a joint analysis of NY and pBFM groups was performed. The control group consisted of 35 patients, aged 6–17 years. The analyzed patients underwent a complex assessment with visual EP (VEP), somatosensory EP (SEP) and brainstem auditory EP (BAEP) in accordance with current standards. Results ALL treatment contributed to the shortening of wave I latency (1.59 vs 1.90, P = 0.003) and prolongation of I-III (2.23 vs 2.04, P = 0.004) and I-V (4.57 vs 4.24, P = 0.002) interwave latencies of BAEP. A significant effect was also noticed in P100 (106.32 vs 101.57, P < 0.001) and N135 (151.42 vs 138.22, P < 0.001) latencies of VEP and N18 amplitude (3.24 vs 4.70, P = 0.007) and P25 latency (21.32 vs 23.39, P < 0.001) of SEP. The distribution of abnormalities between protocols was similar in BAEP (NY - 68.6%, pBFM - 61.7%, BFM95–69.4%, P = 0.650), VEP (NY - 68.6%, pBFM - 42.5%, BFM95–58.3%, P = 0.053) and significantly different for SEP (NY - 62.9%, pBFM - 36.2%, BFM95–53.0%, P = 0.045). The harmful effect of radiotherapy was most clearly marked in numerous disturbances of SEP parameters. Conclusions The presented analysis indicates a high frequency of subclinical abnormalities in EP regardless of the analyzed protocol. To our knowledge current study is the largest and one of the most complex research examining the role of EP in ALL patients. The obtained results indicate the possibility of using a single, objective and non-invasive measurement of EP in ALL survivors in order to stratify the risk of developing sensory abnormalities in adulthood.

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Section: Discussionmentioning

confidence: 96%

Clinical utility of complex assessment with evoked potentials in acute lymphoblastic leukemia survivors: comparison of various treatment protocols

et al. 2021

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“…First, the analyzed patient groups differed in terms of age. However, it has been shown that age is not a signi cant factor modulating EP [23]. Second, in our study we analyzed asymptomatic patients.…”

Section: Discussionmentioning

confidence: 96%

Clinical Utility of Complex Assessment With Evoked Potentials in Acute Lymphoblastic Leukemia Survivors: Comparison of Various Treatment Protocols

Kroczka

Stępień

Witek-Motyl

et al. 2020

Preprint

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Background: One of the largest success in a pediatric hematology is a prominent improvement of survival in acute lymphoblastic leukemia (ALL). Simultaneously, it encourages to focus on long-term effects of the treatment such as neurotoxicity. One of the few diagnostic methods that allow an objective assessment of sensory organization are evoked potentials (EP).Methods: We analyzed the group consisted of 167 ALL long-term survivors, aged 4.9-28.4 years, without auditory, visual and sensory deviations. Patients were treated with New York (NY, n=35), previous modified Berlin-Frankfurt-Münster (pBFM, n=47) and BFM95 (n=85) protocols. In order to assess the impact of radiotherapy on recorded EP, a joint analysis of NY and pBFM groups was performed. The control group consisted of 35 patients, aged 6-17 years. The analyzed patients underwent a complex assessment with visual EP (VEP), somatosensory EP (SEP) and brainstem auditory EP (BAEP) in accordance with current standards.Results: ALL treatment contributed to the shortening of wave I latency (1.59 vs 1.90, P=0.003) and prolongation of I-III (2.23 vs 2.04, P=0.004) and I-V (4.57 vs 4.24, P=0.002) interwave latencies in BAEP. A significant effect was also noticed in P100 (106.32 vs 101.57, P<0.001) and N135 (151.42 vs 138.22, P<0.001) latencies for VEP and N18 amplitude (3.24 vs 4.70, P=0.007) and P25 latency (21.32 vs 23.39, P<0.001) for SEP. The distribution of abnormalities between protocols was similar in BAEP (NY - 68.6%, pBFM - 61.7%, BFM95 - 69.4%, P=0.650), VEP (NY - 68.6%, pBFM - 42.5%, BFM95 - 58.3%, P=0.053) and significantly different for SEP (NY - 62.9%, pBFM - 36.2%, BFM95 - 53.0%, P=0.045). The harmful effect of radiotherapy was most clearly marked in numerous disturbances of SEP parameters.Conclusions: The presented analysis indicates a high frequency of subclinical abnormalities in EP regardless of the analyzed protocol. To our knowledge current study is the largest and one of the most complex research examining the role of EP in ALL patients. The obtained results indicate the possibility of using a single, objective and non-invasive measurement of EP in ALL survivors in order to stratify the risk of developing sensory abnormalities in adulthood.

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Factors Associated With Inadequate Intraoperative Baseline Lower Extremity Somatosensory Evoked Potentials

Chen

Shilian

Cheongsiatmoy

et al. 2018

Journal of Clinical Neurophysiology

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Adequate baselines are paramount for successful intraoperative neurophysiologic monitoring. However, certain patient-specific factors are associated with inadequate baseline SEP signals. Physical examination findings and a detailed chart review can be done to identify these factors and guide expectations during monitoring. Further research related to patient-specific factors amenable to modification can further improve our capacity to protect the nervous system during surgery.

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Somatosensory Evoked Potential for Detection of Subclinical Neuropathy in Egyptian Children with Acute Lymphoblastic Leukaemia

Cited by 3 publications

References 32 publications

Clinical utility of complex assessment with evoked potentials in acute lymphoblastic leukemia survivors: comparison of various treatment protocols

Clinical utility of complex assessment with evoked potentials in acute lymphoblastic leukemia survivors: comparison of various treatment protocols

Clinical Utility of Complex Assessment With Evoked Potentials in Acute Lymphoblastic Leukemia Survivors: Comparison of Various Treatment Protocols

Factors Associated With Inadequate Intraoperative Baseline Lower Extremity Somatosensory Evoked Potentials

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