Advertisement

Neurophysiological Investigation of the Spinal Cord

  • M. S. Schwartz
  • M. Swash
Part of the Clinical Medicine and the Nervous System book series (CLIN.MED.NERV.)

Abstract

The spinal cord is a long structure that extends from the post-cervical segment, lotated just caudal to the foramen magnum, to the conus medullaris which, in adults, is located at about the L1vertebral level. The spinal nerve roots leave the cord by passing slightly caudally to reach the appropriate intervertebral foramina on each side, the ventral and dorsal nerve roots fusing just distal to the posterior root ganglion to form mixed motor and sensory roots. These nerve roots form major branching plexuses in the cervical and lumbosacral regions in which the peripheral nerves innervating the limbs are formed but, in the thoracic region, the mixed nerve roots remain separate and form intercostal nerves. Thus the segmental organization of the human spinal cord reflects the underlying metameric differentiation of body segments in other species.

Keywords

Multiple Sclerosis Motor Unit Neurol Neurosurg Psychiatry Motor Neuron Disease Motor Neurone 
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.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Abbruzzese G, Dall’agata D, Morena M, et al. (1988) Electrical stimulation of the motor tracts in cervical spondylosis. J Neurol Neurosurg Psychiatry 51:796–802PubMedCrossRefGoogle Scholar
  2. Aminoff MJ (1984) The clinical role of somatosensory evoked potential studies: a critical appraisal. Muscle Nerve 7:345–354PubMedCrossRefGoogle Scholar
  3. Ammassian VE, Gracco RQ, Maccabee PJ (1989) Focal stimulation of human cerebral cortex with the magnetic coil: a comparison with electrical stimulation. Electroencephalogr Clin Neurophysiol 74:401–416CrossRefGoogle Scholar
  4. Anderson NE, Frith RW, Synek VM (1986) Somatosensory evoked potentials in syringomyelia. J Neurol Neurosurg Psychiatry 49:1407–1410PubMedCrossRefGoogle Scholar
  5. Angell RW, Hoffmann WW (1963) The H reflex in normal, spastic and rigid subjects. Arch Neurol 9:591–596CrossRefGoogle Scholar
  6. Armon C, Daube JR (1989) Electrophysiological signs of arteriovenous malformations of the spinal cord. J Neurol Neurosurg Psychiatry 52:1176–1181PubMedCrossRefGoogle Scholar
  7. Barker AT, Jalinous R, Freeston IL (1985) Non-invasive magnetic stimulation of human motor cortex. Lancet 2:1106–1107CrossRefGoogle Scholar
  8. Baumhefner RW, Tourtellotte WW, Syndulko K, et al. (1990) Quantitative multiple sclerosis plaque assessment with magnetic resonance imaging. Arch Neurol 47:19–26PubMedCrossRefGoogle Scholar
  9. Berardelli A, Inghilleri M, Formisano R, et al. (1987) Stimulation of motor tracts in motor neuron disease. J Neurol Neurosurg Psychiatry 50:732–737PubMedCrossRefGoogle Scholar
  10. Berger AR, Shahani BT (1989) Electrophysiologic evaluation of spinal cord motor conduction. Muscle Nerve 12:976–980PubMedCrossRefGoogle Scholar
  11. Bernstein LP, Antel JP (1981) Motor neuron disease: dereentai responses to repetitive nerve stimulation. Neurology 31:202–204Google Scholar
  12. Boyd SG, Rothwell JC, Cowan JM, et al. (1986) A method of monitoring function in corticospinal pathways during scoliosis surgery with a note on motor conduction velocities. J Neurol Neurosurg Psychiatry 49:251–257PubMedCrossRefGoogle Scholar
  13. Burke D, Skuse NF, Lethlean AK (1981) Cutaneous and muscle afferent components of the cerebral potential evoked by electrical stimulation of human peripheral nerves. Electroencephalogr Clin Neurophysiol 51:579–588PubMedCrossRefGoogle Scholar
  14. Cashman VR, Maselli, R, Wollman RL, et al. (1987) Late denervation in patients with antecedent paralytic poliomyelitis. N Engl J Med 317:7–12PubMedCrossRefGoogle Scholar
  15. Chatrian GE, Burger MS, Wirch AL (1988) Discrepancy between intraoperative SSEP’s and post-operative function. J Neurosurg 69:450–454PubMedCrossRefGoogle Scholar
  16. Chiappa K (1980) Pattern-shift visual, brain stem auditory and short-latency somatosensory evoked potentials in multiple sclerosis. Neurology 30:110–123PubMedGoogle Scholar
  17. Chiappa KH (1983) Evoked potentials in clinical medicine. Raven, New York, pp 1–340Google Scholar
  18. Chiappa KH, Ropper AH (1982) Evoked potentials in clinical medicine 2. N Engl J Med 306:1205–1211PubMedCrossRefGoogle Scholar
  19. Claus D. Harding AE. Hess CW, et al. (1988) Central motor conduction in degenerative ataxic disorders: a magnetic stimulation study. J Neurol Neurosurg Psychiatry 51:790–795PubMedCrossRefGoogle Scholar
  20. Colon EJ, Rottevell JJ, Stegeman DF, et al. (1988) Abnormal EMG and SSEP in a young child with an ependymoma. Clin Neurol Neurosurg 90:249–252PubMedCrossRefGoogle Scholar
  21. Conradi S, Grimby L, Lundemo G (1982) Pathophysiology of fasciculations in ALS as studied by electromyography of single motor units. Muscle Nerve 5:202–208PubMedCrossRefGoogle Scholar
  22. Cowan JMA, Dick JPR, Day BL, et al. (1984) Abnormalities in central motor pathway conduction in multiple sclerosis. Lancet 2:304–307PubMedCrossRefGoogle Scholar
  23. Cruikshank JK, Rudge P, Dalgliesh AG, et al. (1989) Tropical spastic paraparesis and human T cell lymphotropic virus Type 1 in the United Kingdom. Brain 112:1057–1090CrossRefGoogle Scholar
  24. Dawson GD (1954) A summation technique for the detection of small evoked potentials. Electroencephalogr Clin Neurophysiol 6:65–84PubMedCrossRefGoogle Scholar
  25. Denny-Brown D, Pennybacker JB (1938) Fibrillation and fasciculation in voluntary muscle. Brain 61:311–332CrossRefGoogle Scholar
  26. Dimitrijevic MR (1986) Neurocontrol of the upper motor neuron and progressive neuromuscular diseases. In: Dimitrijevic MR, Kakulas BA, Vrbovâ G (eds) Recent achievements in restorative neurology. 2. Progressive neuromuscular diseases. Karger, Basel, pp 39–52Google Scholar
  27. Donofrio PD, Walker FO (1988) Tabes dorsalis: electrodiagnostic features. J Neurol Neurosurg Psychiatry 51:1087–1089CrossRefGoogle Scholar
  28. Eisen A, Yufe R, Trop D, et al. (1978) Reduced neuromuscular transmission safety factor in multiple sclerosis. Neurology 28:598–602PubMedGoogle Scholar
  29. Eisen A, Shtybel W, Murphy K, et al. (1990) Cortical magnetic stimulation in amyotrophic lateral sclerosis. Muscle Nerve 13:146–151PubMedCrossRefGoogle Scholar
  30. Fincham RW, Cape CA (1968) Sensory nerve conduction in syringomyelia. Neurology 18:200–201PubMedGoogle Scholar
  31. Fine EJ, Soria E, Paroski MW, et al. (1990) The neurophysiological profile of vitamin B12 deficiency. Muscle Nerve 13:158–164PubMedCrossRefGoogle Scholar
  32. Fisher MA (1983) F response analysis of motor disorders of central origin. J Neurol Sci 62:13–22.PubMedCrossRefGoogle Scholar
  33. Ganes T (1980) Somatosensory conduction times and peripheral cervical and cortical evoked potentials in patients with cervical spondylosis. J Neurol Neurosurg Psychiatry 43:683–689PubMedCrossRefGoogle Scholar
  34. Gardner-Thorpe C, Foster JB, Barwick DD (1976) Unusual manifestations of Herpes zoster. J Neurol Sci 28:427–447PubMedCrossRefGoogle Scholar
  35. Gout O, Gessain A, Bolgert F, et al. (1989) Chronic myelopathies associated with human T lymphotropic virus Type 1. Arch Neurol 46:255–260PubMedCrossRefGoogle Scholar
  36. Halstead LS, Rossi CD (1985) New problems in old polio patients: results of a survey of 539 polio survivors. Orthopedics 8:845–853PubMedGoogle Scholar
  37. Harding AE (1984) The hereditary ataxias and related disorders. Churchill Livingstone, EdinburghGoogle Scholar
  38. Harper CM, Daube JR, Litchey WJ, et al. (1988) Lumbar radiculopathy after a spinal fusion for scoliosis. Muscle Nerve 11:386–391PubMedCrossRefGoogle Scholar
  39. Helweg-Larsen S, Jakobsen J, Bosen F, et al. (1988) Myelopathy in AIDS: a clinical, neuroradiological and electrophysiological study of 23 Danish patients. Acta Neurol Scand 77:64–73PubMedCrossRefGoogle Scholar
  40. Hess CW, Mills KR, Murray NMF, et al. (1989) Magnetic brain stimulation: central motor conduction studies in multiple sclerosis. Ann Neurol 22:744–752CrossRefGoogle Scholar
  41. Ingram DA, Swash M (1987) Central motor conduction is abnormal in motor neuron disease. J Neurol Neurosurg Psychiatry 50:159–166PubMedCrossRefGoogle Scholar
  42. Ingram DA, Thompson AJ, Swash M (1988) Central motor conduction in multiple sclerosis: evaluation of abnormalities revealed by transcutaneous magnetic stimulation of the brain. J Neurol Neurosurg Psychiatry 51:487–494PubMedCrossRefGoogle Scholar
  43. Jacobson GP, Tew JM (1987) Intraoperative evoked potential monitoring. J Clin Neurophysiol 4:145–176PubMedCrossRefGoogle Scholar
  44. James PB (1988) Late changes in the motor unit after acute poliomyelitis. Muscle Nerve 4:524–528Google Scholar
  45. Janko M, Trontelj JV, Gersak K (1989) Fasciculation in motor neuron disease: discharge rate reflects extent and recency of collateral sprouting. J Neurol Neurosurg Psychiatry 52:1375–1381PubMedCrossRefGoogle Scholar
  46. Jellinek EH, Tulloch WS (1976) Herpes zoster with dysfunction of bladder and anus. Lancet 2:1219–1222PubMedCrossRefGoogle Scholar
  47. Jones SJ (1977) Short latency potentials recorded from the neck and scalp following median nerve stimulation in man. Electroencephalogr Clin Neurophysiol 43:853–863PubMedCrossRefGoogle Scholar
  48. Kakigi R, Shibasaki H, Kuroda Y, et al. (1988) Multimodality evoked potentials in HTLV-1 associated myelopathy. J Neurol Neurosurg Psychiatry 51:1094–1096PubMedCrossRefGoogle Scholar
  49. Kaplan PW, Hosford DA, Werner MH, et al. (1988) Somatosensory evoked potentials in a patient with a cervical glioma and syrinx. Electroencephalogr Clin Neurophysiol 70:563–565PubMedCrossRefGoogle Scholar
  50. Katifi HA, Sedgwick EM (1986) Somatosensory evoked potentials from posterior tibial nerve and lumbosacral dermatomes. Electroencephalogr Clin Neurophysiol 35:249–259Google Scholar
  51. Kimura J (1983) F wave determination in nerve conduction studies. In: Desmedt JE (ed) Motor control mechanisms in health and disease. Raven, New York, pp 961–975Google Scholar
  52. Kimura J (1985) Abuse and misuse of evoked potentials as a diagnostic test. Arch Neurol 42:78–80CrossRefGoogle Scholar
  53. Kimura J (1989) Electrodiagnosis: in diseases of nerve and muscle, 2nd edk.. Davis, PhiladelphiaGoogle Scholar
  54. Kitagawa H, Itoh T, Takano H, et al. (1989) Motor evoked potential monitoring during upper cervical spine surgery. Spine 14:1078–1083PubMedCrossRefGoogle Scholar
  55. Lesser RP, Lueders H, Dinner DS, et al. (1985) Technical aspects of surgical monitoring using evoked potentials. In: Struppler A, Weindl A (eds) Electromyography and evoked potentials. Springer-Verlag, Berlin, pp 177–180Google Scholar
  56. Lesser RP, Randzens P, Lueders H, et al. (1986) Postoperative neurological deficits may occur despite unchanged intraoperative somatosensory evoked potentials. Ann Neurol 19:22–25PubMedCrossRefGoogle Scholar
  57. Levy WJ (1984) Clinical experience with motor and cerebellar evoked potential monitoring. Neurosurgery 20:169–182Google Scholar
  58. Masur H, Elgar CE, Render K, et al. (1989) Functional deficits of central sensory and motor pathways in patients with cervical spinal stenosis: a study of SEPs and EMG responses to non-invasive brain stimulation. Electroencephalogr Clin Neurophysiol 74:450–457PubMedCrossRefGoogle Scholar
  59. Matthews WB, Beauchamp M, Small DG (1974) Cervical somatosensory evoked responses in man. Nature 252:230–232PubMedCrossRefGoogle Scholar
  60. Matthews WB, Wattam-Bell JRB, Pountney E (1982) Evoked potentials in the diagnosis of multiple sclerosis; a follow up study. J Neurol Neurosurg Psychiatry 45:303–307PubMedCrossRefGoogle Scholar
  61. Matthews WB, Acheson ED, Batchelor JR, Weller RO (1985) McAlpine’s multiple sclerosis. Churchill Livingstone, EdinburghGoogle Scholar
  62. Mayer RF (1965) Peripheral nerve function in vitamin B12 deficiency. Arch Neurol 13:355–362PubMedCrossRefGoogle Scholar
  63. McLeod JG (1971) An electrophysiological and pathological study of peripheral nerves in Friedreich’s ataxia. J Neurol Sci 12:333–349PubMedCrossRefGoogle Scholar
  64. Merton PA, Morton HB (1980a) Stimulation of the cerebral cortex in the intact human subject. Nature 285:227PubMedCrossRefGoogle Scholar
  65. Merton PA, Morton HB (1980b) Electrical stimulation of human motor and visual cortex through the scalp. J Physiol 305:9–10Google Scholar
  66. Mills KR, Murray NMF (1986) Electrical stimulation over the human vertebral column: which neuronal elements are excited? Electroencephalogr Clin Neurophysiol 63:582–589PubMedCrossRefGoogle Scholar
  67. Nurmikko T, Bowsher D (1990) Somatosensory findings in post-herpetic neuralgia. J Neurol Neurosurg Psychiatry 53:135–141PubMedCrossRefGoogle Scholar
  68. Oppenheimer DR (1978) The cervical cord in multiple sclerosis. Neuropathol Appl Neurobiol 4:151–162PubMedCrossRefGoogle Scholar
  69. Panayiotopoulos CP (1979) F chronodispersion: a new electrophysiologic method. Muscle Nerve 2:68–72PubMedCrossRefGoogle Scholar
  70. Pedersen L, Trojaborg W (1981) Visual, auditory and somatosensory pathway involvement in hereditary cerebellar ataxia, Friedreich’s ataxia and familial spastic paraplegia. Electroencephalogr Clin Neurophysiol 52:283–297PubMedCrossRefGoogle Scholar
  71. Peiogolu-Harmoussi S, Fawcett PRW, Howel D, et al. (1989) F response frequency in motor neuron disease and cervical spondylosis. J Neurol Neurosurg Psychiatry 50:593–599CrossRefGoogle Scholar
  72. Petito CK, Cho E-S, Lemann W, et al. (1988) Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review. J Neuropathol Exp Neurol 45:636–646Google Scholar
  73. Roth G (1984) Fasciculations and their F response. J Neurol Sci 63:299–306PubMedCrossRefGoogle Scholar
  74. Rothwell JC, Thompson PD, Day BL, et al. (1987) Motor cortex stimulation in intact man. 1. General characteristics of EMG responses in different muscles. Brain 110:1173–1190PubMedCrossRefGoogle Scholar
  75. Schriefer TN, Hess CW, Mills KR, et al. (1989) Central motor conduction studies in motor neuron disease using magnetic brain stimulation. Electroencephalogr Clin Neurophysiol 74:431–437PubMedCrossRefGoogle Scholar
  76. Schwartz MS, Swash M (1982) Pattern of involvement in the cervical segments in the early stage of motor neuron disease — a single fibre EMG study. Acta Neurol Scand 65:424–431PubMedCrossRefGoogle Scholar
  77. Schwartz MS, Stalberg E, Swash M (1980) Pattern of segmental motor involvement in syringomyelia: a single fibre EMG study. J Neurol Neurosurg Psychiatry 43:150–155PubMedCrossRefGoogle Scholar
  78. Sclabassi RJ, Namerow NS, Enns NF (1974) Somatosensory response to stimulus trains in patients with multiple sclerosis. Electroencephalogr Clin Neurophysiol 37:23–33PubMedCrossRefGoogle Scholar
  79. Sedgwick EM, Katifi HA (1987) How to record and interpret dermatomal somatosensory evoked potentials (DSEP). J Electrophysiol Technol 13:51–60Google Scholar
  80. Smith SJM, Claus D, Hess CW, et al. (1989) F responses and central motor conduction in multiple sclerosis. Electroencephalogr Clin Neurophysiol 74:438–443PubMedCrossRefGoogle Scholar
  81. Smith T, Trojaborg W (1988) Somatosensory evoked potentials and spinal decompression sickness. Lancet 1:364–365PubMedCrossRefGoogle Scholar
  82. Snooks SJ, Swash M (1985) Motor conduction velocity in the human spinal cord: slowed conduction in multiple sclerosis and radiation myelopathy. J Neurol Neurosurg Psychiatry 48:1135–1139PubMedCrossRefGoogle Scholar
  83. Stalberg E (1982) Macroelectromyography in reinnervation. Muscle Nerve 5:S135-S138PubMedGoogle Scholar
  84. Stalberg E, Thiele B (1975) Motor unit fibre density in the extensor digitorum communis muscle. J Neurol Neurosurg Psychiatry 38:874–880PubMedCrossRefGoogle Scholar
  85. Stalberg E, Schwartz MS, Trontelj JV (1975) Single fibre electromyography in various processes affecting the anterior horn cell. J Neurol Sci 24:403–415PubMedCrossRefGoogle Scholar
  86. Stark RJ, Kennard C, Swash M (1981) Hand wasting in spondylitic high cord compression. Ann Neurol 9:58–62PubMedCrossRefGoogle Scholar
  87. Stöhr M, Büttner UW, Riffel B, et al. (1982) Spinal somatosensory evoked potentials in cervical cord lesions. Electroencephalogr Clin Neurophysiol 54:251–265Google Scholar
  88. Swash M, Schwartz MS (1982) A longitudinal study of changes in motor units in motor neuron disease. J Neurol Sci 56:185–197PubMedCrossRefGoogle Scholar
  89. Swash M, Schwartz MS (1988) Neuromuscular diseases, 2nd edn. Springer-Verlag, LondonGoogle Scholar
  90. Swash M, Schotz CL, Vowles G, et al. (1988) Selective and asymmetric vulnerability of corticospinal and cerebellar tracts in motor neuron disease. J Neurol Neurosurg Psychiatry 51:785–789PubMedCrossRefGoogle Scholar
  91. Tang L-M, Schwartz MS, Swash M (1988) Postural effects on F wave in lumbosacral root compression and canal stenosis. Brain 111:13–19CrossRefGoogle Scholar
  92. Thompson PC, Dick JPR, Asselman P, et al. (1987) Examination of motor function in lesions of the spinal cord by stimulation of the motor cortex. Ann Neurol 21:389–396PubMedCrossRefGoogle Scholar
  93. Tornado H, Shibasaki H, Hirata J, et al. (1988) Central versus peripheral nerve conduction before and after treatment of subacute combined degeneration. Arch Neurol 45:526–529CrossRefGoogle Scholar
  94. Ugawa Y, Kohara N, Shimpo T, et al. (1988) Central motor and sensory conduction in adrenoleucomyeloneuropathy, cerebrotendinous xanthomatosis, HTLV-1 associated myelopathy and tabes dorsalis. J Neurol Neurosurg Psychiatry 51:1069–1074PubMedCrossRefGoogle Scholar
  95. Uhthoff W (1889) Untersuchungen über die bei der multiplen Herdsklerose vorkommenden Augenstörungen. Arch Psychiatr Nervenkr 21:55–116, 303–410CrossRefGoogle Scholar
  96. Vanasse M, Garcia Larrea L, Neuschwander P, et al. (1988) Evoked potential studies in Friedreich’s ataxia and progressive early-onset cerebellar ataxia. Can J Neurol Sci 15:292–298PubMedGoogle Scholar
  97. Weichers DO, Hubbell ST (1981) Late changes in the motor unit after acute poliomyelitis. Muscle Nerve 4:524–528CrossRefGoogle Scholar
  98. Weir A, Hansen S, Ballantyne JP (1979) Single fibre electromyographic jitter in multiple sclerosis. J Neurol Neurosurg Psychiatry 42:1146–1150PubMedCrossRefGoogle Scholar
  99. Williams C, Kozlowski MA, Hinton DR, et al. (1990) Degeneration of spinocerebellar neurons in amyotrophic lateral sclerosis. Ann Neurol 27:215–225PubMedCrossRefGoogle Scholar
  100. Zegers de Beyl D, Delecluse F, Verbanck P, et al. (1988) Somatosensory conduction in vitamin B12 deficiency. Electroencephalogr Clin Neurophysiol 69:313–318CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1992

Authors and Affiliations

  • M. S. Schwartz
  • M. Swash

There are no affiliations available

Personalised recommendations