Original Article

Neurological Sciences

, Volume 32, Issue 3, pp 401-410

First online:

Comparison of LEP and QST and their contribution to standard sensory diagnostic assessment of spinal lesions: a pilot study

  • Christian GeberAffiliated withKlinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg Universität Email author 
  • , Ulf BaumgärtnerAffiliated withLehrstuhl für Neurophysiologie, CBTM, Medizinische Fakultät Mannheim der Universität Heidelberg
  • , Marcel FechirAffiliated withKlinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg Universität
  • , Thomas VogtAffiliated withKlinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg Universität
  • , Frank BirkleinAffiliated withKlinik und Poliklinik für Neurologie, Universitätsmedizin der Johannes-Gutenberg Universität
  • , Rolf-Detlef TreedeAffiliated withLehrstuhl für Neurophysiologie, CBTM, Medizinische Fakultät Mannheim der Universität Heidelberg

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Abstract

This study evaluates the additional use of laser-evoked potentials (LEP) and quantitative sensory testing (QST) in the sensory assessment of spinal lesions. Four consecutive patients with spinal lesions verified by MRI and clinical evidence for mild spinothalamic tract involvement were included. The electrophysiological workup [somatosensory evoked potentials (SEP) and LEP] was compared to QST. Electrophysiology and QST were reassessed after about 6 months. LEP detected impaired spinothalamic tract function in 7/8 examinations. QST pointed to spinothalamic tract lesions by loss of thermal function (3/8); most frequent positive sensory signs (3/8) were paradoxical heat sensations. LEP and QST results were concordant in 6/8 examinations. SEPs were abnormal in 2/8 examinations. Congruent results between SEP and both LEP and QST were obtained in 3/8 examinations. LEP detected more deficits than any single QST parameter or their combination but additional QST allows the detection of positive sensory signs. The diagnostic gain of SEP was limited.

Keywords

Quantitative sensory testing (QST) Laser-evoked potentials (LEP) Diagnostic assessment Spinal lesion Spinothalamic tract Neuropathic pain