Article

The evaluation of
patients with myelopathies requires radiological investigations; however, for the
correct interpretation of the neuroimaging findings, the functional assessment of
corticospinal conduction is helpful or even mandatory in many conditions. The
objective of this review article was to assess the utility of the motor evoked
potentials (MEPs) in diagnosis and management of the most frequent spinal cord
disorders. SETTING: Salzburg (Austria) and Merano (Italy). METHODS: A MEDLINE
search was performed using following terms: 'motor evoked potentials',
'transcranial magnetic stimulation', 'central motor conduction', 'compressive
myelopathy', 'spinal cord infarction', 'spinal cord injury', 'syringomyelia',
'myelitis', 'hereditary spastic paraparesis', 'subacute combined degeneration'
and 'hepatic myelopathy'. RESULTS: Central motor conduction abnormalities can be
detected also in the absence of neuroradiological abnormalities-for example, in
patients with subacute combined degeneration or hepatic myelopathy. In the most
frequent patients with compressive myelopathies, MEPs were found to be very
helpful in determining the functional significance of neuroimaging findings. MEP
recording can supplement clinical examination and neuroimaging findings also in
the assessment of the spinal cord injury level. In patients with spinal cord
infarction, the MEP study can demonstrate spinal involvement even when
radiological evidence for spinal cord damage is absent or equivocal, thus
allowing an important early diagnosis. CONCLUSION: MEPs represent a highly
sensitive and accurate diagnostic tool in many different spinal cord disorders.
MEPs can also be useful in follow-up evaluation of motor function during
treatment and rehabilitation.

Langue : ANGLAIS