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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Mixed nerve silent periods recorded from the anterior tibial muscle following tibial nerve stimulation

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  • Mihr Shahnazaryan - Helios Klinikum Erfurt, Klinik für Neurochirurgie, Erfurt, Deutschland
  • Steffen Rosahl - Helios Klinikum Erfurt, Klinik für Neurochirurgie, Erfurt, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocP162

doi: 10.3205/18dgnc503, urn:nbn:de:0183-18dgnc5036

Published: June 18, 2018

© 2018 Shahnazaryan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Silent Periods (SP) are defined as the suppression of voluntary muscle activity in the electromyogramm (EMG) after a painful electrical stimulus. The method has been shown to aid the identification of lesions in the cervical spinothalamic tract (e.g. in syringomyelia). The objective of this study was to establish a similar methodology involving stimulation at the lower limbs in order to diagnose lesions caudal to the cervical spinal cord.

Methods: Mixed nerve silent periods following nociceptive stimulation of the tibial nerve (MNSP-T) were recorded at the skin over the anterior tibial muscle from 14 healthy subjects (9 male and 5 female; mean age 36.6 years). Single square wave pulses (duration 0.2 ms, intensity 90 mA) were applied and ten single EMG sweeps were recorded in each subject with filters set at 20 and 5000 Hz.

Results: In 10 subjects (6 male and 4 female) nociceptive stimulation completely suppressed the EMG for a mean duration of 44.64 ms (range 32 – 55.8ms, SD = 8ms). The mean onset latency for silent periods was 105.99 ms (range 93.4-124.4 ms, SD = 9.37ms). In 4 subjects (3 male, 1 female) no EMG suppression was registered. No significant differences in duration and latency of SP were found between males and females. There were also no significant differences in the extent and latency of SP according to the side of stimulation.

Conclusion: The study introduces a new diagnostic method for recording silent periods of the tibial muscle after nociceptive stimulation of the tibial nerve. It contributes reference values for the duration and latency of MNSP-T in healthy subjects. Irregular MNSP-T should only be interpreted in combination with a neurological exam and radiological data.