PubMed · 7332961
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Z Tománek, M Lébl, J Skruzný, V Nedvĕd. 1981. [An electrogustometer for routine clinical practice].. https://pubmed.ncbi.nlm.nih.gov/7332961/
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The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques (somatosensory evoked potentials [SSEP], motor evoked potentials [MEP], and electroneuromyographic recordings [ENMG]) to assess the extent and severity of a spinal cord injury. An essential advantage of these techniques in comparison with clinical examination is that they can also be reliably applied in uncooperative patients. These techniques allow early prognosis regarding the functional deficit in patients with acute spinal cord injury. Recordings of tibial nerve somatosensory evoked potentials and motor evoked potentials of the anterior tibial muscle serve to predict the outcome of ambulatory capacity, and pudendal nerve somatosensory evoked potentials that of bladder function. In tetraplegic patients median and ulnar nerve somatosensory evoked potentials and motor evoked potentials of the abductor digiti min. muscle may indicate the outcome of hand function at an early stage. The electroneuromyographic recordings make it possible to differentiate between the proportion of peripheral and central nervous lesion underlying a muscle paresis. This is of prognostic value in regard to the development of muscle tone and consequently for planning of therapy. The electrophysiological examinations are of complementary value in the diagnostic assessment of spinal cord lesions, in the prediction of functional outcome, and in monitoring the course of neurological deficits. This is helpful for planning and selection of appropriate therapeutic approaches within the rehabilitation programme.
Electrogastrography (EGG) is a method for recording and analysis of the bioelectrical activity of the stomach, acquired by cutaneous electrodes. The problem of obtaining an EGG signal as free of artefact as possible has recently found some solutions. Good quality recordings of several hours duration can be acquired, often needed, especially if clinical applications are envisaged. Therefore, a next problem to be considered would be time-compressed presentation of the EGG signal without loss of relevant signal characteristics. Relative amplitude changes can be of clinical value, while frequency variations are traditionally regarded as more important. A method for simple compressed presentation of long term EGG recordings, without losing information about the real amplitude and/or frequency changes or transients, is presented. It makes use of detection of successive wave extrema in an EGG. Successive wave amplitudes and durations are measured and momentaneous frequencies are derived. Then a compressed two-trace plot is generated, representing amplitude and frequency variations with respect to time. The method is virtually insensitive to baseline drift, as only the peak amplitudes are detected and followed. A compression factor with respect to the traditional signal recording (1 cm min(-1) or 2 cm min(-1) paper speed) of 5 up to 15 per trace can be obtained.
These examples illustrate the interplay of the electrophysiologic techniques of SEP, EMG, NCAPs, and nerve conduction studies to achieve the goals of monitoring, guiding, identifying and localizing, and assessing nerve function. Through their successful application, intraoperative neurophysiology moves from solely monitoring to serving as an electrophysiologic aid to the surgeon. Using all of these techniques provides a comprehensive analysis of nerve function. The overall goal is both to prevent intraoperative neural compromise and to optimize postoperative outcome by providing the surgeon with the best possible information regarding the functional condition of the nerves under investigation.