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November 1985

Somatosensory Evoked Potentials in Thoracic Outlet Syndrome

Author Affiliations

Department of Neurology Massachusetts General Hospital and Harvard Medical School Boston, MA 02114

Arch Neurol. 1985;42(11):1036. doi:10.1001/archneur.1985.04060100014007

To the Editor.  —Over 450 musicians have been seen for occupational upper-limb complaints at the Massachusetts General Hospital, Boston, over the past five years. Of these patients, 38 have had clinical evidence of thoracic outlet syndrome (TOS). We noted with particular interest the article by Jerrett et al,1 in which somatosensory evoked potentials were studied in patients with clinical TOS, because reliable, objective criteria for this diagnosis are lacking.2 Seventeen of their 18 patients had abnormalities on this examination. We have attempted to validate this examination in our musician patients.Five consecutive patients with clear clinical evidence of TOS were subjected to upper-limb somatosensory evoked potentials (Table). All had positive stress tests on clinical examination and at least two months of symptoms. None had clinical evidence of brachial plexopathy. Chest roentgenograms ruled out abnormal cervical ribs in all cases. Somatosensory evoked potentials were performed with particular attention to