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Journal of the Korean Academy of Rehabilitation Medicine 1998;22(6):1219-1224.
Changes of Dermatomal Somatosensory Evoked Potentials in the Children with Spastic Cerebral Palsy after Selective Posterior Rhizotomy.
Park, Eun Sook , Park, Chang Il , Shin, Ji Cheol , Kim, Seong Woo , Baek, Soh Young
1Department of Rehabilitation Medicine, Yonsei University College of Medicine.
2Research Institute of Rehabilitation, Yonsei University College of Medicine.
경직성 뇌성마비 환아에서 선택적 후근 절제술 후의 체성감각 유발전위 변화
박은숙, 박창일, 신지철, 김성우, 백소영
연세대학교 의과대학 재활의학교실 및 재활의학연구소
Abstract

Objective
To evaluate the changes of dermatomal SEP (DSEP) in children with a spastic cerebral palsy (CP) after the selective posterior rhizotomy (SPR).


Method
The subjects were 14 spastic CP children, with the age from 3 to 6 years old, who underwent SPR. DSEPs were studied at the L2-3, L4, L5, S1 dermatomes bilaterally, pre and postoperatively. Postoperative DSEPs were interpreted by the changes of latency, amplitude and waveforms.


Results
1) All children were spastic diplegia except one who was a spastic hemiplegia. 2) Preoperative DSEPs were flat or severely distorted in 40 of 112 waveforms (34.5%). 3) Postoperative DSEP latencies were no change in 39.3%, improved in 17.9%, and worsened in 25.6% respectively. Amplitudes were no change in 30.8%, improved in 38.5%, and worsened in 13.7% respectively. Waveforms were no change in 64.1%, improved in 22.2%, and worsened in 8.5% respectively. There was no statistical difference of postoperative changes of the 3 categories according to the root levels.


Conclusion
The results showed that the preoperative DSEPs were abnormal in 34.5% suggestive the lesions of CP being more widespread than strictly involving the motor system. This study confirmed that the most SEPs unchanged by the SPR. A further study for the relationship of postoperative DSEP changes and clinical findings such as functional impairment would be needed.

Key Words: Cerebral palsy, Dermatomal somatosensory evoked potential, Selective posterior rhizotomy, Spasticity


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