Skip to main content

Advertisement

SpringerLink
Log in

Canal lombaire étroit, explorations neurophysiologiques: électromyographie et potentiels évoqués

Narrow lumbar canal: neurophysiological investigations. Electromyography and evoked potentials

  • Dossier Thématique
  • Published:
La Lettre de médecine physique et de réadaptation

Résumé

La multiplication des techniques qui ont fait leurs preuves dans le diagnostic des atteintes radiculaires lombaires conduit l’électrophysiologiste à faire le choix des tests les mieux adaptés à une symptomatologie donnée, et à les hiérarchiser. L’électromyographie à l’aiguille reste la plus performante parce que la plus sensible, la plus spécifique, et la seule démontrant le caractère évolutif des lésions. La conduction proximale est appréciée par l’analyse des ondes tardives (réflexe H, réflexe bulbocaverneux, onde F). Si l’EMG est négatif ou discordant avec la clinique, les potentiels moteurs ou somesthésiques métamériques peuvent aussi apporter un diagnostic topographique de lésion radiculaire. Dans le cas du canal lombaire étroit, le potentiel évoqué somesthésique permet en outre de vérifier l’intégrité de la fonction médullaire sus-jacente.

Abstract

A number of electrophysiological tests are used in the diagnosis of nerve root defects. Practitioners must select the most appropriate tests based on the clinical presentation of each case. Needle EMG is the most reliable method because of its high sensitivity and specificity, and it is the only technique capable of demonstrating the clinical course of lesions over time. Proximal conduction is assessed by examining late responses (H-reflex and F-wave). If negative or inconsistent, motor evoked potentials and dermatomal somatosensory evoked potentials can reveal the extent of the nerve root lesion. In the case of lumbar spinal stenosis, spinal function is assessed using somatosensory evoked potentials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Jensen MC, Brant-Zawadzki MN, Obuchowski N, et al. (1994) Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med Jul 14, 331(2): 69–73

    Article  CAS  Google Scholar 

  2. Levin KH (2002) Electrodiagnostic approach to the patient with suspected radiculopathy. Neurol Clin N Am 20: 397–421

    Google Scholar 

  3. Hausser-Hauw C, Koutlidis RM (1989) Intérêt des potentiels évoqués moteurs pour la localisation des lésions radiculaires. Rev Neurol (Paris) 145(11): 771–75

    CAS  Google Scholar 

  4. Haig AJ, Tong HC, Yamakawa KS, et al. (2005) The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis. Spine 30(23): 2667–76

    Article  PubMed  Google Scholar 

  5. Lomen-Hoerth C, Aminoff MJ (1999), Clinical physiologic studies: Which test and when? Neurol Clin N Am 17(1): 65–74

    CAS  Google Scholar 

  6. Guiheuneuc P, Ginet J, Describs P, et al. (1973) Hoffman reflex in lumbo-sacral roots injuries. EEG Clin Neurophysiol 34: 814–15

    Google Scholar 

  7. Magladery JW, McDougal DB (1950) Electrophysiological studies of nerve and reflex activity in normal man. Identification of certain reflexes in the electromyogram and the conduction velocity of peripheral nerves fibres. Bull Johns Hopkins Hospital 86: 265–90

    CAS  Google Scholar 

  8. Fisher MA (2002) H reflex and F waves fundamentals, normal and abnormal pattern. Neurol Clin N Am 20: 339–60

    Google Scholar 

  9. Ertekin C, Reel F (1976) Bulbocavernosus reflex in normal men and in patients with neurogenic bladder and/or impotence. J Neurol Sci 28(1): 1–15

    Article  PubMed  CAS  Google Scholar 

  10. Amarenco G, Kerdraon J (2000) Clinical value of ipsi and contralateral sacral reflex latency measurement: a normative data study in man. Neurourol Urodyn 19(5): 565–76

    Article  PubMed  CAS  Google Scholar 

  11. Eisen A (1986) SEP in the evaluation of the peripheral nervous system in “Evoked potentials”, Frontiers of clinical Neurosciences (ed.), Cracco Bodis-Wollner, Alan R. Liss Inc 3: 409–417

  12. Debatisse D, Desfontaines P, Selaki I, et al. (1994) L’apport diagnostic et pronostic des potentiels évoqués somesthésiques par stimulation tronculaire et dermatomale dans les conflits discoradiculaires lombaires. Rev Neurol (Paris), 150: 220–28

    Google Scholar 

  13. Maertens De Noordhout A, Rothwell JC, Thompson PD, et al. (1988) Percutaneous electrical stimulation of lumbosacral roots in man. J Neurol Neurosurg Psychatry 51(2): 174–81

    Article  CAS  Google Scholar 

  14. Merton PA, Morton HB (1980) Stimulation of the cerebral cortex in the intact human subject. Nature 285: 227

    Article  PubMed  CAS  Google Scholar 

  15. Barker AT, Jalinous R, Freeston IL (1985) Non-invasive magnetic stimulation of the human motor cortex. Lancet 1: 1106–07

    Article  PubMed  CAS  Google Scholar 

  16. Bischoff C, Meyer BU, Machetanz J, et al. (1993) The value of magnetic stimulation in the diagnosis of radiculopathies. Muscle Nerve 2: 154–61

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. 12, rue Jean-Dolent, F-75014, Paris, France

    R. Morizot Koutlidis

Authors
  1. R. Morizot Koutlidis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Morizot Koutlidis.

About this article

Cite this article

Morizot Koutlidis, R. Canal lombaire étroit, explorations neurophysiologiques: électromyographie et potentiels évoqués. Lett Med Phys Readapt 23, 30–34 (2007). https://doi.org/10.1007/s11659-007-0054-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11659-007-0054-y

Mots clés

Keywords

Search

Navigation