Abstract
This 16-year-old female patient suffers from double vision (diplopia) and sensory disturbances in the right side of her face. In addition, she could not walk for about 15 min after getting out of bed one morning. She has remaining numbness and cramps in her legs, since. Neurological testing shows that her right trigeminal nerve, the main sensory nerve of the face, is indeed not functioning well. Two years ago, she suffered from an inflammation of her left optical nerve (optic neuritis). At that time, an MRI showed three white matter lesions indicative for demyelination. She was treated with anti-inflammatory drugs successfully. A new MRI now shows a lesion in the white matter in the midbrain.
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Online Sources of Information
http://en.wikipedia.org/wiki/Evoked_potentials short overview of topics treated in this chapter, with many links to related topics
Books
Chiappa KH (1997) Evoked potentials in clinical medicine. Lippincott-Raven, Philidelphia
Ebersole JS and Pedley TA (2003) Current practice of clinical electroencephalography. Lippincott, Williams and Wilkins, Philadelphia (Chapters 27–29 and 31 in particular)
Papers
Dawson GD (1954) A summation technique for the detection of small evoked potentials. Electroencephalogr Clin Neurophysiol 6:65–84
Ness JM, Chabas D, Sadovnick AD, Pohl D, Banwell B, Weinstock-Guttman B; for the International Pediatric MS Study Group (2007) Cl7inical features of children and adolescents with multiple sclerosis. Neurology 68(16):S37–S45
Van de Wassenberg W, van der Hoeven J, Leenders K, Maurits N (2008) Multichannel recording of median nerve somatosensory evoked potentials. Neurophysiol Clin 38:9–21
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Glossary
- Axonal degeneration
-
Response of a peripheral nerve to damage, leading to death and breakdown of the axon and finally of the myelin sheath.
- Demyelination
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Damage of the fatty myelin sheath around nerve axons. The myelin sheath electrically insulates the nerve, such that nerve signal conduction can proceed efficiently.
- Dermatome
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Area of skin that is mainly innervated by a single spinal nerve.
- Gyri
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The ridges of the cortex.
- Habituation
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A decrease in a response due to repeated regular stimulation.
- Inhibition
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Suppression of activity in the nervous system.
- Myelopathy
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Pathology of the spinal cord, in the example in the text leading to compression of the spinal cord.
- Oligoclonal bands
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Bands that can be seen in blood serum or cerebrospinal fluid indicating the presence of antibodies.
- Phase-locked
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Fixed in time to the same moment in the signal period.
- Plexus brachialis
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A bundle of nerve fibers exciting from the spinal cord at level C5-T1 and running through the neck and armpit into the arm.
- Polarity
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The sign of an EP component, i.e., positive or negative.
- Scoliotic
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A curved spine.
- Stationary
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The statistical properties do not change over time.
- Sulci
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The folds of the cortex.
- Topography
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Here: the distribution of potentials over the scalp.
- Volley
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A simultaneous discharge of several action potentials.
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Maurits, N. (2012). Multiple Sclerosis, Evoked Potentials, and Enhancing Signal-to-Noise Ratio. In: From Neurology to Methodology and Back. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1132-1_5
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DOI: https://doi.org/10.1007/978-1-4614-1132-1_5
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