Somatosensory evoked potentials and the dorsal column myth.

Somatosensory evoked potentials (SEPs) are believed to travel primarily if not totally over the dorsal column (DC) system. The modalities of joint position sense and vibration are said to be mediated by the DCs. The authors cite classic and recent literature as well as their own work to reveal a lack of consistent agreement between clinical sensory (neurological examination) and electrophysiological (SEP) data regarding DC dysfunction. Documentation of this discrepancy is presented, and potential causes are examined. The authors conclude that, despite the classic tenets, there is not testable modality specific to the DC. Instead, there is likely a transmission of several proprioceptive modalities, not limited to the DC, that ascend variously in the spinal cord and are integrated at a higher level to produce somesthetic appreciation.