Median Nerve SSEP:- Is there a relationship between Median Nerve SSEP & Level of Spinal Cord Injury?

This case study was conducted by the American Spinal Cord Injury Association (ASIA) on patients with Quadriplegia. The question asked was is there a relationship between median nerve SSEP changes and level of spinal cord injury?.

The answer is yes, neuromonitoring of median nerve SSEPs conducted on 14 quadriplegic patients and 8 normal individuals. Amplitude and latency analysis of waveforms N9, N13 and N20 was conducted. N9 responses were present in all the patients and normal subjects, both amplitude and latency were similar in both groups.

On the other hand, N13 was absent in Quadriplegia patients?
N20 was absent in C5 patients with Quadriplegia? but it was present in C6-7 patients, though the amplitudes were decreased with normal latency. Did you notice these waveform changes in your recording?.

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Original Article

Spinal Cord (2009) 47, 372–378; doi:10.1038/sc.2008.147; published online 20 January 2009

Relationship between median nerve somatosensory evoked potentials and spinal cord injury levels in patients with quadriplegia

M I F de Arruda Serra Gaspar¹, A Cliquet Jr^2,3, V M Fernandes Lima⁴ and D C C de Abreu¹

Methods:

Fourteen individuals with quadriplegia and 8 healthy individuals were evaluated. Electrophysiological assessment of the median nerve was performed by evoked potential equipment. The injury level was obtained by ASIA. N₉, N₁₃ and N₂₀ were analyzed based on the presence or absence of responses. The parameters used for analyzing these responses were the latency and the amplitude. Data were analyzed using mixed-effect models.