Comparison of LEP and QST and their contribution to standard sensory diagnostic assessment of spinal lesions: a pilot study

Neurol Sci. 2011 Jun;32(3):401-10. doi: 10.1007/s10072-011-0476-9. Epub 2011 Feb 4.

Abstract

This study evaluates the additional use of laser-evoked potentials (LEP) and quantitative sensory testing (QST) in the sensory assessment of spinal lesions. Four consecutive patients with spinal lesions verified by MRI and clinical evidence for mild spinothalamic tract involvement were included. The electrophysiological workup [somatosensory evoked potentials (SEP) and LEP] was compared to QST. Electrophysiology and QST were reassessed after about 6 months. LEP detected impaired spinothalamic tract function in 7/8 examinations. QST pointed to spinothalamic tract lesions by loss of thermal function (3/8); most frequent positive sensory signs (3/8) were paradoxical heat sensations. LEP and QST results were concordant in 6/8 examinations. SEPs were abnormal in 2/8 examinations. Congruent results between SEP and both LEP and QST were obtained in 3/8 examinations. LEP detected more deficits than any single QST parameter or their combination but additional QST allows the detection of positive sensory signs. The diagnostic gain of SEP was limited.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Electrodiagnosis / methods
  • Evoked Potentials, Somatosensory / physiology*
  • Evoked Potentials, Somatosensory / radiation effects*
  • Female
  • Humans
  • Lasers*
  • Male
  • Neurologic Examination / methods
  • Pain Measurement / methods
  • Pilot Projects
  • Predictive Value of Tests
  • Sensory Thresholds / physiology*
  • Sensory Thresholds / radiation effects*
  • Somatosensory Disorders / diagnosis*
  • Somatosensory Disorders / physiopathology
  • Spinal Cord Diseases / diagnosis*
  • Spinal Cord Diseases / physiopathology