The Importance of Motor Evoked Potential Findings in Acute-Subacute Odontoid Dislocations

Year 2023, Volume: 7 Issue: 3, 188 - 191, 30.09.2023

Amber Eker , Bahar Kaymakamzade Kubilay Varlı

https://doi.org/10.30621/jbachs.1070760

Abstract

Background:
Motor evoked potentials (MEPs) using transcranial magnetic stimulation (TMS) may give a functional assessment of corticospinal conduction. The aim of this study is to confirm the value of MEPs for the assessment of the dysfunction in spinal cord transmission in patients with clinically minimally symptomatic or asymptomatic and acute-subacute odontoid pathologies.
Methods:
We measured the MEPs of five cases with acute-subacute odontoid dislocations by using TMS. Demografic features, neurological examinations and neuroimaging findings of the patients have also been noted.
Results:
The CMCTs and MEP latencies after cortical stimulus of all patients with acute-subacute odontoid dislocation prolonged bilaterally. Additionally, MEP amplitudes were observed decreased in all cases.
Conclusions:
MEP is quite valuable to show involvement in clinically and radiologically silent cases. Our findings in acute-subacute cases without myelopathy showed us that the CMCTs were prolonged especially in the cases who had motor defisits but also in asymptomatic cases.

Keywords

Motor Evoke Potentials, odontoid, acute, subacute, electrophysiology, adult

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1- Nakamae T, Tanaka N, Nakanishi K et al. Quantitative assessment of myelopathy patients using motor evoked potentials produced by transcranial magnetic stimulation. Eur Spine J. 2010;19(5):685–690.
• 2- Mut M, Cila A, Varli K, Akalan N. Multilevel myelopathy in Maroteaux-Lamy syndrome and review of the literature. Clinical Neurology and Neurosurgery. 2005 Apr;107(3):230-235.
• 3- Di Lazzaro V, Oliviero A, Profice P et al. The diagnostic value of motor evoked potentials. Clin Neurophysiol. 1999 Jul;110(7):1297-307.
• 4- Mazur MD, White A, McEvoy S, Bisson EF. Transcranial magnetic stimulation of the motor cortex correlates with objective clinical measures in patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976). 2014 Jun 15;39(14):1113-20.
• 5- Kameyama O, Shibano K, Kawakita H, Ogawa R. Transcranial magnetic stimulation of the motor cortex in cervical spondylosis and spinal canal stenosis. Spine (Phila Pa 1976). 1995 May 1;20(9):1004-10.
• 6- Dhall SS, Haefeli J, Talbott JF et al. Motor Evoked Potentials Correlate With Magnetic Resonance Imaging and Early Recovery After Acute Spinal Cord Injury. Neurosurgery. 2018 Jun 1;82(6):870-876.
• 7- O'Brien WT Sr, Shen P, Lee P. The Dens: Normal Development, Developmental Variants and Anomalies, and Traumatic Injuries. J Clin Imaging Sci. 2015 Jun 30;5:38.
• 8- Nakanishi K, Tanaka N, Kamei N et al. Electrophysiological evidence of functional improvement in the corticospinal tract after laminoplasty in patients with cervical compressive myelopathy: clinical article. J Neurosurg Spine. 2014 Aug;21(2):210-6.
• 9- AlEissa SI, Alhandi AA, Bugis AA et al. The incidence of odontoid fractures following trauma in a major trauma center, a retrospective study. J Craniovert Jun Spine.2020;11( 2): 71-74
• 10- Fox S., Allen L., Norton J. Neurophysiological monitoring of displaced odontoid fracture reduction in a 3-year-old male. Spinal Cord Ser Cases 4, 52 (2018). https://doi.org/10.1038/s41394-018-0088-1