Posterior Tibial Somatosensory Evoked Potential as a Prognostic Factor in Spinal Cord Decompression Sickness

Lee, Seung-Hyun; Kim, Jee-Eun; Kim, Hee-Tae; Ahn, Jin-Young

Original article

Korean Journal of Neuromuscular Disorders 2018;10(2):32-36.

Seung-Hyun Lee, Jee-Eun Kim, Hee-Tae Kim, Jin-Young Ahn

1Department of Neurology, Seoul Medical Center, Seoul; 2Department of Neurology, Hanyang Universitly College of Medicine, Seoul, Korea

척수형 감압병에서 후경골신경감각유발전위의 예후 예측 효과

이승현, 김지은, 김희태, 안진영

서울의료원 신경과1, 한양대학교 의과대학 신경과학교실2

Abstract

Background
Somatosensory evoked potentials are the electrical potentials generated in sensory pathways at peripheral, spinal, subcortical and cortical levels of the nervous system. Such electrical potential is frequently used to evaluate myelopathy. This study aims to determine the utility of initial posterior tibial somatosensory evoked potential (PTSEP) as a prognostic factor associated with the development of severe diving-related spinal cord decompression sickness (DCS). Methods: In order to conduct the study, 68 injured divers presenting the symptoms of spinal cord DCS from Seoul Medical Center were included in the study. The patients were divided into two groups normal PTSEP group (n=34) and abnormal PTSEP group (n=34). Diving information, time interval between symptom onset and hyperbaric treatment were studied and analyzed accordingly. The initial severity of spinal cord DCS were then rated using the Boussuges severity score and muscle power examination. The presence of sequelae was evaluated at 2 weeks. Initial recompression treatment at2.8-4 ATA (atmospheres absolute) with 100% oxygen breathing or deeper recompression. Results: Analysis of the results showed that there were no significant differences between each group in age, diving experience, depth of dive, bottom time of dive, onset to treatment, Boussuges’s score and the grade of motor power before the treatment. Marked motor power improvements were noticed in initial normal PTSEP group (70.6%) than abnormal group (29.4%). There were significant differences in degrees of motor power improvement between two groups (p=0.003). Conclusions: Initial PTSEP can be a useful prognostic factor in spinal type DCS.