Usefulness of the combined motor evoked and somatosensory evoked potentials for the predictive index of functional recovery after primary pontine hemorrhage

Jin Wan Seong; Min Ho Kim; Hyo Keong Shin; Han Do Lee; Jun Bum Park; Dong Seok Yang

doi:10.5535/arm.2014.38.1.13

Usefulness of the combined motor evoked and somatosensory evoked potentials for the predictive index of functional recovery after primary pontine hemorrhage

Ann Rehabil Med. 2014 Feb;38(1):13-8. doi: 10.5535/arm.2014.38.1.13. Epub 2014 Feb 25.

Authors

Jin Wan Seong¹, Min Ho Kim², Hyo Keong Shin¹, Han Do Lee³, Jun Bum Park⁴, Dong Seok Yang¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
² Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
³ Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea.
⁴ Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Abstract

Objective: To investigate the predictive index of functional recovery after primary pontine hemorrhage (PPH) using the combined motor evoked potential (MEP) and somatosensory evoked potential (SEP) in comparison to the hematoma volume and transverse diameter measured with computerized tomography.

Methods: Patients (n=14) with PPH were divided into good- and poor-outcome groups according to the modified Rankin Score (mRS). We evaluated clinical manifestations, radiological characteristics, and the combined MEP and SEP responses. The summed MEP and SEP (EP sum) was compared to the hematoma volume and transverse diameter predictive index of global disability, gait ability, and trunk stability in sitting posture.

Results: All measures of functional status and radiological parameters of the good-outcome group were significantly better than those of the poor-outcome group. The EP sum showed the highest value for the mRS and functional ambulatory category, and transverse diameter showed the highest value for "sitting-unsupported" of Berg Balance Scale.

Conclusion: The combined MEP and SEP is a reliable and useful tool for functional recovery after PPH.

Keywords: Motor evoked potential; Pontine hemorrhage; Predictive Index; Somatosensory evoked potential.