Evoked Potentials in Nondemyelinating Diseases

  • François Mauguière
Part of the Topics in Neurosurgery book series (TINS, volume 2)


Evoked potentials (EPs) represent the only noninvasive method available to assess in “real time” the processing of sensory information in the human central nervous system. Most of the successes of this low cost investigation in clinical practice is due to its ability to disclose silent lesions causing delayed response in demyelinating diseases. In nondemyelinating processes the clinical appUcations of EPs have not yet been clearly defined; however in such diseases, EPs may be helpful: 1) to test sensory functions when clinical examination is not reliable (young children, comatose patients, suspected conversion disorder); 2) to decide whether more sophisticated or more invasive morphological investigations should be entertained in patients with purely subjective symptoms; 3) to assess the causative mechanisms of the neurological deficit or of the functional recovery. There are two questions that should be discussed before looking at the diagnostic yield of EPs in nondemyelinating processes: what is the specificity and localizing value of abnormal EP patterns? Is it possible to give unequivocal pathophysiological interpretation of abnormal waveforms?


Median Nerve Brachial Plexus Optic Neuritis Evoke Potential Hereditary Spastic Paraplegia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aminoff MJ, Maitland CG, Kennard C, Hoyt WF: Visual evoked potentials and field defects. In: Evoked Potentials II. RH Nodar and C Barber (eds) Butterworth Publishers, Boston: 329–334, 1984.Google Scholar
  2. 2.
    Anziska BJ and Cracco RW: Short latency somatosensory evoked potentials: studies in patients with focal neurological disease. Electroencephalogr Clin Neurophysiol, 49:227–239, 1980.PubMedCrossRefGoogle Scholar
  3. 3.
    Anziska BJ and Cracco RW: Short latency SEPs to median nerve stimulation: comparison of recording methods and origin of components. Electroencephalogr Clin Neurophysiol 52: 531–539, 1981.PubMedCrossRefGoogle Scholar
  4. 4.
    Blumhardt LD, Barrett J, Kriss A, Halliday AM: The pattern evoked potential in lesions of the posterior visual pathways. Ann NY Acad Sei 338:264–289, 1982.CrossRefGoogle Scholar
  5. 5.
    Bodis-Wollner I, Onofrjm: System diseases and visual evoked potential diagnosis in neurology: changes due to synaptic malfunction. Ann NY Acad Sei 338:327–348, 1982.CrossRefGoogle Scholar
  6. 6.
    Carroll WM, Kriss A, Baraitser M, Barrett G, Halliday AM: The incidence and nature of visual pathway involvement in Friedreich’s ataxia. Brain 103:413–434, 1980.PubMedCrossRefGoogle Scholar
  7. 7.
    Celesia GG, Polcyn RD, Holden JE, Nickles RJ, Gatley JS, Koeppe RA: Visual evoked potentials and positron tomographic mapping of regional cerebral blood flow and cerebral metabolism; can the neuronal potential generators be visualized? Electroencephalogr Clin Neurophysiol 54:243–256, 1982.PubMedCrossRefGoogle Scholar
  8. 8.
    Celesia GG, Todd Meredith J, Pluff K: Perimetry, visual evoked potentials and visual evoked spectral array in homonymous hemianopia. Electroencephalogr Clin Neurophysiol 56:16–30, 1983.PubMedCrossRefGoogle Scholar
  9. 9.
    Chiappa KH and Ropper AH: Evoked potentials in clinical medicine. New Engl J Med 306: 1140–1150 and 1205–1211, 1982.Google Scholar
  10. 10.
    Chiappa KH: Evoked potentials in chnical medicine. Raven Press NY, 1983.Google Scholar
  11. 11.
    Cosi V, Poloni M, Mazzini L, Callieco R: Somatosensory evoked potentials in amyotrophic lateral sclerosis. J Neuro Neurosurg Psychiat 47:857–861, 1984.CrossRefGoogle Scholar
  12. 12.
    Cracco RO: Spinal evoked response: peripheral nerve stimulation in man. Electroencephalogr Clin Neurophysiol 35:379–386, 1973.PubMedCrossRefGoogle Scholar
  13. 13.
    Dawson GD: Investigations on a patient subject to myoclonic seizures after sensory stimulation. J Neurol Neurosurg Psychiat 10:141–162, 1947.PubMedCrossRefGoogle Scholar
  14. 14.
    Deiber MP, Giard MH, Mauguiere F: Separate generators with distinct orientations for N20 and P22 somatosensory evoked potentials to fmger stimulation? Electroencephalogr Clin Neurophysiol 65:321–334, 1986.PubMedCrossRefGoogle Scholar
  15. 15.
    Desmedt JE: Cerebral evoked potentials in: “Peripheral Neuropathy” PJ Dyck, PK Thomas, EH Lambert and R Bunge (eds): Saunders, Philadelphia. 1045–1066, 1984.Google Scholar
  16. 16.
    Desmedt JE and Cheron G: Central somatosensory conduction in man: Neural generators and interpeak latencies of the far-field components recorded from neck and right or left scalp or earlobes. Electroencephalogr Clin Neurophysiol 50, 382–403, 1980.PubMedCrossRefGoogle Scholar
  17. 17.
    Desmedt JE and Cheron G: Noncephalic reference recording of early somatosensory potentials to fmger stimulation in adult or aging man: differentiation of widespread N18 and contralateral N20 from the prerolandic P22 and N30 components. Electroencephalogr Clin Neurophysiol 52:553–570, 1981.PubMedCrossRefGoogle Scholar
  18. 18.
    Desmedt JE and Cheron G: Spinal and far-field components of human somatosensory evoked potentials to posterior tibial nerve stimulation analysed with oesophageal derivations and noncephalic reference recording. Electroencephalogr Clin Neurophysiol 56:635–651, 1983.PubMedCrossRefGoogle Scholar
  19. 19.
    Desmedt JE, Tran Huy N, Carmelier J: Unexpected latency shifts of the stationary P9 somatosensory evoked potential far field with changes in shoulder position. Electroencephalogr Clin Neurophysiol 56:628–634, 1983.PubMedCrossRefGoogle Scholar
  20. 20.
    Desmedt JE and Nguyen TH: Bit-mapped colour imaging of the potential fields of propagated and segmental subcortical components of somatosensory evoked potential in man. Electroencephalogr Clin Neurophysiol 62:1–17, 1984.Google Scholar
  21. 21.
    Desmedt JE and Bourguet M: Color imaging of parietal and frontal somatosensory potential fields evoked by stimulation of median or posterior tibial nerve in man. Electroencephalogr Clin Neurophysiol 62:1–17, 1985.PubMedGoogle Scholar
  22. 22.
    Dimitrijevic MR, Lenman JAR, Prevee T, Wheatly K: A study of posterior column function in familial spastic paraplegia. J Neurol Neurosurg Psychiat 45:46–49, 1982.PubMedCrossRefGoogle Scholar
  23. 23.
    Ehle AL, Stewart RM, Lellehd NE, Leventhal A: normal checkerboard pattern reversal evoked potentials in Parkinsonism. Electroencephalogr Clin Neurophysiol 54:336–338, 1982.PubMedCrossRefGoogle Scholar
  24. 24.
    Fine EJ and Hallett M: Neurophysiological study of subacute combined degeneration. J Neurol Sci 45:331–336, 1980.PubMedCrossRefGoogle Scholar
  25. 25.
    Gandevia SC, Burke D, McKeon BB: The projection of muscle afferents from hand to cerebral cortex in man. Brain 107:1–13, 1984.PubMedCrossRefGoogle Scholar
  26. 26.
    Ganes T: Somatosensory conduction times and peripheral, cervical and cortical evoked potentials in patients with cervical spondylosis. J Neurol Neurosurg Psychiat 43:683–689, 1980.PubMedCrossRefGoogle Scholar
  27. 27.
    Graff-Radford NR, Damasio H, Yamada T, Eslinger PJ, Damasio AR: Nonhemorrhagic thalamic infarction: clinical, neuropsychological and electrophysiological findings in four anatomical groups defined by computerized tomography. Brain 108:485–516, 1985.PubMedCrossRefGoogle Scholar
  28. 28.
    Halliday AM: The electrophysiological study of myoclonus in man. Brain 90:241–284, 1967.PubMedCrossRefGoogle Scholar
  29. 29.
    Halliday AM: Evoked potentials in clinical testing. Churchill Livingstone, Edinburg, 1982.Google Scholar
  30. 30.
    Halliday AM, Wakefield GS: Cerebral evoked potentials in patients with dissociated sensory loss. J Neurol Neurosurg Psychiat 26:211–219, 1963.PubMedCrossRefGoogle Scholar
  31. 31.
    Hennerici M, Homberg V, Lange HW: Evoked potentials in patients with Huntington’s disease and their offspring. Visual evoked potentials. Electroencephalogr Clin Neurophysiol 62:167–176, 1985.PubMedCrossRefGoogle Scholar
  32. 32.
    Hume AL, Cant BR: Conduction time in central somatosensory pathways. Electroenccp- halogr Clin. Neurophysiol 45:361–375, 1978.Google Scholar
  33. 33.
    Jabbari B, Schwartz D, Chikarmane A, Fadden D: Somatosensory and brainstem auditory evoked response abnormalities in a family with Friedreich’s ataxia. Electroencephaloiwr Clin Neurophysiol 53:24–25, 1982.Google Scholar
  34. 34.
    Jones SJ: Investigation of brachial plexus traction lesions by peripheral and spinal somatosensory evoked potentials. J Neurol Neurosurg Psychiat 42:l07–116, 1979.Google Scholar
  35. 35.
    Jones SJ, Baraitser M, Halliday AM: Peripheral and central somatosensory nerve conduction defects in Friedreich’s ataxia. J Neurol Neurosurg Psychiat 43:495–503, 1980.PubMedCrossRefGoogle Scholar
  36. 36.
    Jorg J, Dullberg W, Koeppen S: Diagnostic value of segmental somatosensory evoked potentials in cases with chronic para- or tetraspastic syndromes—in: “Clinical applications of evoked potentials in neurology” J Courjon, F Mauguière and M Revol. Eds Adv Neurol 32:347–358. Raven Press NY, 1982.Google Scholar
  37. 37.
    Kimura J, Mitsudome A, Beck DO, Yamada T, Dickins QS: Field distribution of antidromically activated digital nerve potential: model for far-field recording. Neurology. 33:1164–1169, 1983.PubMedGoogle Scholar
  38. 38.
    Kooi KA, Tipton AC, Marshall R. Polarities and field configurations of the vertex components of the auditory evoked response: reinterpretation. Electroencephalogr Clin Neurophysiol 31:166–169, 1971.PubMedCrossRefGoogle Scholar
  39. 39.
    Kuruoiwa Y and Celesia GG: Visual evoked potentials with hemifield pattern stimulation. Their use in the diagnosis of retrochiasmatic lesions. Arch Neurol 38:86–90, 1981.CrossRefGoogle Scholar
  40. 40.
    Louis AA, Gupta P, Perkash I: Localization of sensory levels in traumatic quadriplegia by segmental somatosensory evoked potentials. Electroencephalogr Clin Neurophysiol 62: 313–316, 1985.PubMedCrossRefGoogle Scholar
  41. 41.
    Lueders H, Andrish J, Gurd A, Wiecker G, George K: Origins of far-field subcortical potentials evoked by stimulation of the posterior tibial nerve. Electroencephalogr Clin Neurophysiol 52:336–344, 1981.PubMedCrossRefGoogle Scholar
  42. 42.
    Mastaglia FL, Black JL, Edis R, Collins DWK: Contribution of evoked potentials in the functional assessment of the somatosensory pathway. Clin Exp Neurol 15:279–298, 1978.PubMedGoogle Scholar
  43. 43.
    Mauguiere F and Courjon J: Effects of intravenously injected clonazepam on the cortical somatosensory evoked response in dyssynergia cerebellaris myoclonica. in “EEG and Clinical Neurophysiology” H Lechner and A Aranibar (eds) 433–444. Excerpta Medica Amsterdam,Google Scholar
  44. 44.
    Mauguiere F, Bard J, Courjon J: Les potentiels evoqués somesthésiques précoces dans la dyssynergie cerebelleuse myoclonique progressive. Rev EEG Clin Neurophysiol 11:174–182,Google Scholar
  45. 45.
    Mauguiere F, Brunon AM, Echallier JF, Courjon J: Early somatosensory evoked potentials in thalamocortical lesions of the lemniscal pathways in humans, in: Clinical Applications of Evoked Potentials in Neurology. J Courjon, F Mauguière and M Revol (eds) Advances in Neurology. Vol 32. Raven Press, New York: 321–338, 1982a.Google Scholar
  46. 46.
    Mauguiere F, Brechard S, Pernier J, Courjon J, Schott B: Anosognosia with hemiplegia: Auditory evoked potential studies. In: Clinical Applications of Evoked Potentials in Neurology. J Courjon, F Mauguière and M Revol (eds) Advances in Neurology. Vol 32. Raven Press, New York: 271–278, 1982b.Google Scholar
  47. 47.
    Mauguiere F: Les potentiels évoqués somesthésiques cervicaux chez le sujet normal. Analyse des aspects obtenus selon le siège de lélectrode de référence. Rev. EEG Clin Neurophysiol 13: 259–272, 1983.Google Scholar
  48. 48.
    Mauguiere F, Schott B, Courjon J: Dissociation of early SEP components in unilateral traumatic section of the lower medulla. Ann Neurol 13:309–313, 1983a.CrossRefGoogle Scholar
  49. 49.
    Mauguiere F, Desmedt JE, Courjon J: Neural generators of N18 and PI4 far-field somatosensory evoked potentials studied in patients with lesions of thalamus or thalamocortical radiations. Electroencephalogr Clin Neurophysiol 56, 283–292, 1983b.CrossRefGoogle Scholar
  50. 50.
    Mauguiere F, Desmedt JE, Courjon J, Astereognosis and dissociated loss of frontal or parietal components of somatosensory evoked potentials in hemispheric lesions. Brain 106, 271–311, 1983c.PubMedCrossRefGoogle Scholar
  51. 51.
    Mauguiere F and Ibanez V. The dissociation of early SEP components in lesions of the cervico-medullary junction: a cue for routine interpretation of abnormal cervical responses to median nerve stimulation. Electroencephalogr Clin Neurophysiol 62:406–420, 1985.PubMedCrossRefGoogle Scholar
  52. 52.
    Mauguiere F, Ibanez V, Fischer C: Les potentiels évoqués somesthésiques dans les tumeurs intra-rachidiennes. Rev EEG Clin Neurophysiol 15:95–106, 1985.Google Scholar
  53. 53.
    Mauguiere F: Short-latency somatosensory evoked potentials to upper limb stimulation in lesions of brainstem, thalamus and cortex. Suppl: 39 to Electroencephalogr Clin Neurophysiol “The London Symposia” Xlth International Congress of EEG and Clinical Neurophysiology RJ, Ellingson, NMF Murray, AM Halliday (Eds) Elsevier. (Amsterdam) p 302–309, 1987.Google Scholar
  54. 54.
    Merton PA, Morton HB: Stimulation of the cerebral cortex in the intact normal subject. Nature. 285:227, 1980.PubMedCrossRefGoogle Scholar
  55. 55.
    Michel F, Peronnet F, Schott B: A propos d’un cas de surdité de l’hémisphère gauche (hémianacousie droite). Rev EEG Clin Neurophysiol 6:175–178, 1976.Google Scholar
  56. 56.
    Michel F and Peronnet F: A case of cortical deafness: Clinical and electrophysiological data. Brain Lang 10:367–377, 1980.PubMedCrossRefGoogle Scholar
  57. 57.
    Michel F, Peronnet F, Mauguiere F: Right hemiancousia without language deficit. In: Clinical Applications of Evoked Potentials in Neurology. J Courjon, F. Mauguière and M Revol (eds) Advances in Neurology. Vol 32. Raven Press, New York: 257–261, 1982.Google Scholar
  58. 58.
    Nakanishi T, Shimada Y, Sakuta M, Toyokura Y: The initial positive component of the scalp recorded somatosensory evoked potential in normal subjects and in patients with neurological disorders. Electroencephalogr Clin Neurophysiol 45, 26–34, 1978.PubMedCrossRefGoogle Scholar
  59. 59.
    Noel P and Desmedt JE: Somatosensory pathway in Friedreich’s ataxia. Acta Neurol Belg 76:271, 1976.Google Scholar
  60. 60.
    Noel P and Desmedt JE: Cerebral and far-field somatosensory evoked potentials in neurological disorders involving the cervical spinal cord, brainstem, thalamus and cortex, in: “Clinical uses of cerebral, brainstem, and spinal somatosensory evoked potentials”. Desmedt JE (ed) Prog Clin Neurophysiol 7; Karger. Basel. 205–230, 1980.Google Scholar
  61. 61.
    Nuwer MR, Perlman SL, Packwood JW, Kark RAP: Evoked potential abnormalities in the various inherited ataxias. Ann Neurol 13:20–27, 1983.PubMedCrossRefGoogle Scholar
  62. 62.
    Obeso JA, Roth well JC, Marsden CD: The spectrum of cortical myoclonus: from focal reflex jerks to spontaneous motor epilepsy. Brain 108:193–224, 1985.PubMedCrossRefGoogle Scholar
  63. 63.
    Pedersen L, Trojaborg W: Visual, auditory and somatosensory pathway involvement in hereditary cerebellar ataxia, Friedreich’s ataxia and familial spastic paraplegia. Electroencephalogr Clin Neurophysiol 52:283–297, 1981.PubMedCrossRefGoogle Scholar
  64. 64.
    Peronnet F, Michel F, Echallier F, Girod J: Coronal topography of human auditory evoked responses. Electroencephalogr Clin Neurophysiol 37:225–230, 1974.PubMedCrossRefGoogle Scholar
  65. 65.
    Peronnet F and Michel F: The asymmetry of the auditory evoked potentials in normal man and in patients with brain lesions, in: “Auditory evoked potentials in man. Psychopharmaco- logy correlates of EPs”. JE Desmedt (ed) Prog Clin Neurophysiol 2:130–141. Karger Basel, 1977.Google Scholar
  66. 66.
    Perot PL and Vera CL: Scalp-recorded somatosensory evoked potentials to stimulation of nerves in the lower extremities and evaluation of patients with spinal cord trauma. Ann NY Acad Sei 388:359–368, 1982.CrossRefGoogle Scholar
  67. 67.
    Rothwell JC, Obeso JA, Marsden CD: On the significance of giant somatosensory evoked potentials in cortical myoclonus. J Neurol Neurosurg Psychiat 47:33–42, 1984.PubMedCrossRefGoogle Scholar
  68. 68.
    Sauer M: Somatosensible Leitungsmessungen bei neurologischen Systemerkrankungen: neurale Muskelatrophien und spinocerebelläre Ataxien. Arch Psychiatr Nervenkr 228:223–242, 1980.PubMedCrossRefGoogle Scholar
  69. 69.
    Scherg M and Von Cramon D: Two bilateral souces of the late AEPs as identified by a spatiotemporal dipole model. Electroencephalogr Clin Neurophysiol 62:32–44, 1985.PubMedCrossRefGoogle Scholar
  70. 70.
    Shibasaki H, Kuroiwa Y: Electroencephalographic correlates of myoclonus. Electroencephalogr Clin Neurophysiol 39:455–463, 1975.PubMedCrossRefGoogle Scholar
  71. 71.
    Shibasaki H, Yamashita Y, Neshige R, Tobimatsu S, Fukui P: Pathogenesis of giant somatosensory evoked potentials in progressive myoclonic epilepsy. Brain 108:225–240, 1985a.PubMedCrossRefGoogle Scholar
  72. 72.
    Shibasaki H, Neshige R, Hashiba Y. Cortical excitabiHty after myoclonus. Jerk-locked somatosensory evoked potentials. Neurology 35:36–41, 1985b.PubMedGoogle Scholar
  73. 73.
    Semp JC, Tamas LB, Stolov WC, Wyler AR: Somatosensory evoked potentials after removal of somatosensory cortex in man. Electroencephalogr Clin Neurophysiol 65:111–117, 1986.CrossRefGoogle Scholar
  74. 74.
    Spehlmann R, Gross RA, HO SU, Leestma JE, Norcross KA. Visual evoked potentials and post-mortem findings in a case of cortical blindness. Ann Neurol 2:531–534, 1977.PubMedCrossRefGoogle Scholar
  75. 75.
    Stohr M, Dichgans J, Voigt K, Buettner UW: The significance of somatosensory evoked potentials for localization of unilateral lesions within the cerebral hemispheres. J Neurol Sei 61:49–63, 1983.CrossRefGoogle Scholar
  76. 76.
    Synek VM: Validity of median nerve somatosensory evoked potentials in the diagnosis of supraclavicular brachial plexus lesions. Electroencephalogr Clin Neurophysiol 65:27–35, 1986.PubMedCrossRefGoogle Scholar
  77. 77.
    Taylor MJ, Chan-Lui WY, Logan WJ: Longitudinal evoked potential studies in hereditary ataxias. Can J Neurol Sei 12:100–105, 1985.Google Scholar
  78. 78.
    Thomas PK, Jefferys JGR, Smith IS, Loulakakis D: Spinal somatosensory evoked potentials in hereditary spastic paralplcgia. J Neurol Neurosurg Psychiat 44:243–246, 1981.PubMedCrossRefGoogle Scholar
  79. 79.
    Vaughan HG and Ritter W: The sources of auditory evoked responses recorded from the human scalp. Electroencephalogr Clin Neurophysiol 28:360–367, 1970.PubMedCrossRefGoogle Scholar
  80. 80.
    Vaughan HG, Ritter W, Simson P: Topographic analysis of auditory event-related potentials in: Motivation, Motor, and Sensory Processes of the Brain. Kornhuber HH and Dceckc L (eds) Prog in Brain Res Vol 54, Elsevier Amsterdam: 279–285, 1980.Google Scholar
  81. 81.
    Waxman S: Membranes, myelin, and the pathophysiology of multiple sclerosis. New Engl J Med 306:1529–1533, 1982.PubMedCrossRefGoogle Scholar
  82. 82.
    Wolpaw JR, Wood CC: Scalp distribution of human auditory evoked potentials. I: Evaluation of reference electrode sites. Electroencephalogr Clin Neurophysiol 54:15–24, 1982.PubMedCrossRefGoogle Scholar
  83. 83.
    Wood CC, Cohen D, Cuffm BN, Yarita M, Allison T: Electrical sources in human somatosensory cortex: identification by combined magnetic and potential recordings. Science 227:1051–1053, 1985.PubMedCrossRefGoogle Scholar
  84. 84.
    Woods DL, Knight RT, Neville HJ: Bitemporal lesions dissociate auditory evoked potentials and perception. Electroencephalogr Clin Neurophysiol 57:208–220, 1984.PubMedCrossRefGoogle Scholar
  85. 85.
    Yamada T, Machida M, Kimura M: Far-field somatosensory evoked potentials after stimulation of the tibial nerve in man. Neurology 32:1151–1158, 1982.PubMedGoogle Scholar
  86. 86.
    Yamada T, Kayamori R, Kimura J, Beck DO Topography of somatosensory evoked potentials after stimulation of the median nerve. Electroencephalogr Clin Neurophysiol 59, 29–43, 1984.PubMedCrossRefGoogle Scholar
  87. 87.
    Yamada T, Graff-Radford NR, Kimura J, Dickins QS, Adams HP. Topographic analysis of somatosensory evoked potentials in patients with well-localized thalamic infarctions. J Neurol Sei 68, 31–46, 1985.CrossRefGoogle Scholar
  88. 88.
    Yu YL and Jones SJ: Somatosensory evoked potentials in cervical spondylolysis. Correlation of median, ulnar and posterior tibial nerve responses with clinical and radiological findings. Brain 108:273–300, 1985.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers, Boston 1989

Authors and Affiliations

  • François Mauguière

There are no affiliations available

Personalised recommendations