Clinical evaluation criteria for the assessment of impaired pain sensitivity by thulium-laser evoked potentials

Abstract Objectives : Cortical potentials evoked by carbon dioxide laser pulses have been applied in clinical practice to study nociceptive pathways for several years. In this study, we evaluate the properties of an infrared laser (thulium-YAG) with a penetration depth in the skin that matches the intracutaneous depth of nociceptors. Methods : Temperature measurements and modelling showed that the thulium laser generates painful intracutaneous temperatures with less surface heating than the carbon dioxide laser and with no side effects (up to 600 mJ pulse energy). To develop clinical evaluation criteria, laser-evoked potentials (LEPs) were recorded from 3 midline positions (Fz, Cz, Pz) vers…

Functional MRI of human primary somatosensory and motor cortex during median nerve stimulation.

Abstract Objectives: Somatosensory evoked potential (SEP) studies suggested that some early cortical SEP components may be generated in the primary motor cortex (M1) rather than the primary somatosensory cortex (S1). Methods: We now used functional magnetic resonance imaging (fMRI) to study activation of S1 and M1 by electrical median nerve stimulation in healthy volunteers. Results: The hand areas of both S1 and M1 showed significant activation (correlation coefficients >0.45) in 7 of 9 subjects (activated volume S1>M1). For comparison, a sequential finger opposition task significantly activated S1 in 7 and M1 in all 9 subjects (activated volume M1>S1). Conclusions: These data show that th…

141. Transcranial magnetic stimulation of the facial nerve in acute isolated peripheral facial palsy

Sensitivity of laser-evoked potentials versus somatosensory evoked potentials in patients with multiple sclerosis

Somatosensory evoked potentials (SEPs) play a less important role in the diagnosis of multiple sclerosis (MS) than visually evoked potentials. Since standard SEPs only reflect the dorsal column function, we now investigated spinothalamic tract function in patients with MS using laser-evoked potentials (LEPs).LEPs to thulium laser stimuli (3ms, 540 mJ, 5mm diameter) were recorded from 3 midline positions (Fz, Cz, Pz) in 20 patients with MS, and 6 patients with possible but unconfirmed MS. Peak latencies and peak-to-peak amplitude of the vertex potential negativity (N2) and positivity (P2) were evaluated and compared with normative values from 22 healthy control subjects. Median and tibial ne…