Early impairment of somatosensory evoked potentials in very young children with achondroplasia with foramen magnum stenosis

Stefania Fornarino, Daniela Paola Rossi, Mariasavina Severino, Angela Pistorio, Anna Elsa Maria Allegri, Simona Martelli, Laura Doria Lamba, Paola Lanteri

Research output: Contribution to journalArticlepeer-review

Abstract

AIM: To evaluate the contribution of somatosensory evoked potentials after median nerve (MN-SEPs) and posterior tibial nerve (PTN-SEPs) stimulation in functional assessment of cervical and lumbar spinal stenosis in children with achondroplasia.

METHOD: We reviewed MN-SEPs, PTN-SEPs, and spinal magnetic resonance imaging (MRI) examinations performed in 58 patients with achondroplasia (25 males, 33 females; age range 21d-16y 10mo; mean age 4y 3mo [SD 4y 1mo]). Patients were subdivided into four age categories: <2 years, between 2 to 4 years, between 4 to 8 years, and ≥8 years. The peak latency of P37 for PTN-SEPs, the peak latencies of N11, N13, P14, and N20, and the N13-N20 interpeak latency (IPL) for MN-SEPs were collected; the diagnostic accuracy measures of these parameters (analysis of receiver operating characteristic [ROC] curves) with respect to the presence of foramen magnum or lumbar spinal stenosis were analysed in each age category.

RESULTS: The ROC curve analysis showed that the most sensitive parameter in detecting the presence of foramen magnum stenosis was P37 latency in the first two age categories (<2y and ≥2-4y; sensitivity 0.63, specificity 1.00, and sensitivity 1.00, specificity 0.75 respectively). In the third age category (≥4-8y), the most sensitive parameter in detecting the presence of foramen magnum stenosis was IPLs N13-N20 (sensitivity 0.73, specificity 0.87), whereas in the last age category (≥8y), the most important parameter was N20 latency (sensitivity 0.75, specificity 0.77).

INTERPRETATION: In children with achondroplasia, the cortical component of PTN-SEPs is more sensitive than the cortical component and central conduction time of MN-SEPs in detection of cervical spinal cord compression at early ages.

Original languageEnglish
Pages (from-to)192-198
Number of pages7
JournalDevelopmental Medicine and Child Neurology
Volume59
Issue number2
DOIs
Publication statusPublished - Feb 2017

Keywords

  • Achondroplasia
  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Constriction, Pathologic
  • Electric Stimulation
  • Evoked Potentials, Somatosensory
  • Female
  • Foramen Magnum
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • ROC Curve
  • Reaction Time
  • Spinal Cord
  • Tibial Nerve
  • Journal Article

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