Significance of electrophysiological recordings in predicting functional recovery of patients with spinal cord injury

Abstract

The clinical assessment of the extent and severity of spinal cord injury (SCI) can be supplemented by electrophysiological data (somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), and electroneurography. Electrophysiological examinations are advantageous over clinical examinations, as they can reliably be applied also in uncooperative patients. They provide an early diagnosis of the functional deficit in patients with acute SCI and are predictive of recovery of specific functions. The results of tibial nerve SSEP and MEP of the anterior tibial muscle allow the prediction of the outcome of ambulatory capacity, and pudendal nerve SSEP that of bladder function. In tetraplegic patients median and ulnar nerve SSEP and MEP of the abductor digiti min. muscle can indicate the development of hand function. Finally, neurographic recordings of upper and lower limbs allow differentiation between the proportion of peripheral and central nerve lesion underlying muscle paresis. This is of prognostic value in regard to the development of muscle tone and consequently for planning of an adequate therapy. Thus, electrophysiological examinations complement the assessment of spinal cord lesion, they arc predictive of functional outcome, and are able to monitor the course of neurological deficit. Therefore, the data are helpful for planning and selecting the appropriate therapeutical approaches (e.g. functional electrical stimulation, application of botulinum toxin, splinting procedures) within the rehabilitation programme.