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December 1986

Short-Latency Somatosensory-Evoked Potentials From Radial, Median, Ulnar, and Peroneal Nerve Stimulation in the Assessment of Cervical Spondylosis: Comparison With Conventional Electromyography

Author Affiliations

From the Laboratory of Clinical Neurophysiology, Department of Neurology, Harvard Medical School, and Massachusetts General Hospital, Boston. Dr Yiannikas is presently with the Department of Clinical Neurophysiology, Sydney University, and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Arch Neurol. 1986;43(12):1264-1271. doi:10.1001/archneur.1986.00520120046015

• A study of data on 30 patients with cervical spondylosis was carried out to determine whether short-latency somato-sensory-evoked responses (SEPs) to median, ulnar, radial, and peroneal nerve stimulation provided additional information to that obtained by electromyography (EMG), late responses, and peripheral conduction studies. Peripheral studies, EMG results and SEPs were within normal limits in ten patients with pain, but without objective neurological deficit. By contrast, of ten patients who had objective signs of root compression, conventional EMG results were normal in nine, but abnormalities of the SEPs from radial nerve stimulation were obtained in only five patients, and were normal from ulnar and median nerve stimulation. In ten patients with clinical features of myelopathy, seven had abnormal median SEPs and all had abnormal peroneal SEPs, whereas EMG results were abnormal in only five patients. It is suggested that SEPs and EMG are both of limited use in patients with only symptoms of root compression. In patients with signs of root compression, EMG is the most sensitive procedure; however, some additional information can be obtained from superficial radial SEPs. In patients with cervical myelopathy, SEP was the most useful procedure, especially when upper and lower limbs were studied.