O Papazian1, I Alfonso, V F García. 1. Division de Neurofisiología Clínica, Departamento de Neurología, Miami Children's Hospital, Miami, FL 33155, USA.
Abstract
OBJECTIVE: The purpose of this review is to demostrate the value and limitations of neurophysiological evaluation of children with peripheral neuropathy. DEVELOPMENT: The neurophysiological evaluation (NPE) is an extension of the neurologic examination. The NPE has a high diagnostic sensitiviy but lacks etiologic specificity. The NPE includes motor and sensory nerve conduction velocity studies (NCV), needle EMG, somatosensory evoked potential (SEP) and motor evoked potential (MEP). The NCV allows to determine the component of the peripheral nerve fiber involved (axon and/or myelin), type of fibers affected (motor and/or sensory), the location of the lesion (proximal and/or distal) and the pattern of the nerve involvement (segmental or continuos). The EMG allows to determine the presence and degree of denervation and reinervation. CONCLUSIONS: The combination of NCV, EMG, SEP and MEP allow: 1. To localize a lesion to the diferent regions of the peripheral nervous system (preganglionic and/or postganglionic segments of dorsal root, ventral root, spinal nerve, plexus and peripheral nerves); 2. To determine severity and prognosis; 3. To select candidates for reconstructive exploratory surgery; and 4. To determine treatment efficacy and/or natural course of the disease
OBJECTIVE: The purpose of this review is to demostrate the value and limitations of neurophysiological evaluation of children with peripheral neuropathy. DEVELOPMENT: The neurophysiological evaluation (NPE) is an extension of the neurologic examination. The NPE has a high diagnostic sensitiviy but lacks etiologic specificity. The NPE includes motor and sensory nerve conduction velocity studies (NCV), needle EMG, somatosensory evoked potential (SEP) and motor evoked potential (MEP). The NCV allows to determine the component of the peripheral nerve fiber involved (axon and/or myelin), type of fibers affected (motor and/or sensory), the location of the lesion (proximal and/or distal) and the pattern of the nerve involvement (segmental or continuos). The EMG allows to determine the presence and degree of denervation and reinervation. CONCLUSIONS: The combination of NCV, EMG, SEP and MEP allow: 1. To localize a lesion to the diferent regions of the peripheral nervous system (preganglionic and/or postganglionic segments of dorsal root, ventral root, spinal nerve, plexus and peripheral nerves); 2. To determine severity and prognosis; 3. To select candidates for reconstructive exploratory surgery; and 4. To determine treatment efficacy and/or natural course of the disease