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Early impairment of somatosensory evoked potentials in very young children with achondroplasia with foramen magnum stenosis
Author(s) -
Fornarino Stefania,
Rossi Daniela Paola,
Severino Mariasavina,
Pistorio Angela,
Allegri Anna Elsa Maria,
Martelli Simona,
Doria Lamba Laura,
Lanteri Paola
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.13243
Subject(s) - achondroplasia , somatosensory evoked potential , foramen magnum , medicine , stenosis , receiver operating characteristic , median nerve , lumbar , radiology , anatomy , surgery , anesthesia
Aim To evaluate the contribution of somatosensory evoked potentials after median nerve ( MN ‐ SEP s) and posterior tibial nerve ( PTN ‐ SEP s) stimulation in functional assessment of cervical and lumbar spinal stenosis in children with achondroplasia. Method We reviewed MN ‐ SEP s, PTN ‐ SEP s, and spinal magnetic resonance imaging ( MRI ) examinations performed in 58 patients with achondroplasia (25 males, 33 females; age range 21d–16y 10mo; mean age 4y 3mo [ SD 4y 1mo]). Patients were subdivided into four age categories: <2 years, between 2 to 4 years, between 4 to 8 years, and ≥8 years. The peak latency of P37 for PTN ‐ SEP s, the peak latencies of N11, N13, P14, and N20, and the N13–N20 interpeak latency ( IPL ) for MN ‐ SEP s were collected; the diagnostic accuracy measures of these parameters (analysis of receiver operating characteristic [ ROC ] curves) with respect to the presence of foramen magnum or lumbar spinal stenosis were analysed in each age category. Results The ROC curve analysis showed that the most sensitive parameter in detecting the presence of foramen magnum stenosis was P37 latency in the first two age categories (<2y and ≥2–4y; sensitivity 0.63, specificity 1.00, and sensitivity 1.00, specificity 0.75 respectively). In the third age category (≥4–8y), the most sensitive parameter in detecting the presence of foramen magnum stenosis was IPL s N13–N20 (sensitivity 0.73, specificity 0.87), whereas in the last age category (≥8y), the most important parameter was N20 latency (sensitivity 0.75, specificity 0.77). Interpretation In children with achondroplasia, the cortical component of PTN ‐ SEP s is more sensitive than the cortical component and central conduction time of MN ‐ SEP s in detection of cervical spinal cord compression at early ages.