Somatosensory Evoked Potential

I recently had a SSEP done and the results came back with a report on the legs of unable to read due to artifact.  What would produce the aritfact?  The technician spent several hours trying to get the study done and could not get my foot to "twitch" when stimulated.  The doctor wants the study repeated and I need to know if it would just be another abnormal result or if the time and effort are worthwhile.

[CCF Neuro[P] MD, RPS]

Dear Lavon Lockwood:

I can't answer your question.  I did not do the test, I don't know what the other readings were proximal to the legs, I didn't talk to the technician who was doing the test, and although I remember you name, I don't know the particulars of your disease.  Artifacts can be from the patient:moving, cold extremities, not cooperative or the machine: leads not functioning, machine not working correctly, electrical interference.  The SSEP looks at the central processing of sensory firing from the brain to the extremities.  I am assuming that your neurologist is looking for a central process, such as demyelination or axonal loss to account for sensory changes?  Anyway, I would allow him/her to repeat the study as I am assuming that the information is important.

CCF Neuro MD

[Allison]

If I could kind doctor ask some information from you regarding the SSEP test.  I had one back in 98 which show latency in the lower extremities, left more so than right.  Since that time they have found a chronic radiculopathy in the right leg which causes no problem with back pain, I believe the damage was done in the early 90's when I did have some problems.  I continue to have spreading numbness with negative mri's which started in my feet and is now midcalf, in my hands, buttocks, and a large area on upper/mid level back going around the left rib.  I think the only thing they found was a small hemangioma on the t12 which was probably there at birth and nothing to worry about.  They have tested bloods repeatedly for lupus, etc.  negative only thing was a slight positive of ana at 1:40 speckled.  Brain mri's negative too. I believe they are planning to check for sarcoidosis with some tissue from my sinuses when I have to have surgery on them.

Would it be helpful to repeat the ssep within the year to check for possible changes in the latency of my legs and also to see if it has spread to the arms. Would it even be beneficial to repeat the test, I know it must have clinical correlation with it. Is it possible to have "hidden" lesions in the spine for a two year period?

Thank you so much for your time and forum.

[Lavon Lockwood]

I was given a diagnosis of PLS in December but when I went to the local ALS clinic the neurologist who directs it said she believes my symptom pattern is more like MS.  I have had a negative visual evoked potential and BAER.  The SSEP of the arms was negative too but the legs were a problem.  The tech switched out leads, re-did all the scans, and I was warm and did not talk or move during the four hours the tech tried to get the study (slept through much of it).  I believe the tech did it right which leaves me in a quandry about what went wrong.  Since there is not an obvious problem with the testing I suspect it is something with me.  I really don't care about the diagnosis except MS does have some treatment options and I would like to slow this down if possible.  Thanks for the information.  Lavon

[CCF Neuro[P] MD, RPS]

Dear Allison:

It would be much easier to follow your clinical course clinically and not with an evoke potential test.

CCF Neuro MD

[Your Opinion Please]

I just received the results of SSEP's on Lower limbs.  There is an abnormal finding in that it is "borderline abnormal"  The neuro is not worried, but is sending me for an MRI.  He has suggested that after an MRI, the results are normal in 9/10 cases-when results such as mine are seen.  Do you have any thoughts on this or what has been your experience?

[CCF Neuro[P] MD, RPS]

Dear Your Opinion Please:

I would agree with your neurologist.  A borderline abnormality can be within the realm of error or technical variation.  The MRI, if it is normal would also verify the finding.  It sounds like your neurologist is trying to be thorough, and that is a good sign.

CCF Neuro MD

[Dear Doctor]

Thanks you for your comments regarding the SSEP results.
Your Opinion Please.  (This is an amazing site, and you are amazing!)

[cici]

Many years ago I was diagnosed with a hiatal hernia.  It became worse recently and my doctor said I have reflux.  I have also been vomiting after eating.  I can't bend over or the food will come out.  It also feels like my esophagus is getting burnt. A year ago I also had lasering of my eyelids and forehead and got herpes in and around my eye from the laser.  After a herpes outbreak in my temple I had face pain and pulsating in my ear.  The face pain went away with accupucture near the ear but I still get a feeling that something is in the tissue around my ear.  I also have worse neck pain than usual.  It feels like there's a stick on one side.  I have had 3 small dizzy spells lasting moments where I feel like eveything shut off momentarilly. Also my throat in front on the sides of the adams apple feels stiff. A year ago I also had facial surgery and they put a jackson prat drain in my scalp to the back of my neck. I also had an abdominalplasty which was filling my abdomen up with blood for awhile and had to be drawn out with a big sringe. The area around my stomach feels hard and kind of numb.  Could any of these things cause the dizzy spells or vomiting? Do these symptoms indicate anything?  I'm worried that they may be TIA's.

[CCF Neuro[P] MD, RPS]

Dear Cici:

From your description, these events are likely not TIAs.  As the name implies the symptoms are transitory lasting only minutes then the patient is back to normal.  The most likely explanation is the surgeries having a part to play in the pain.

CCF Neuro MD