[Recording of subcortical somatosensory evoked potentials using nasopharyngeal electrodes--a study in sedated patients]. 1988

W Wagner
Neurochirurgische Universitätsklinik Mainz.

Nasopharyngeal recording of evoked potentials is only seldom used, and a systematic description of subcortical SEP derivations using this method is essentially lacking. In twelve patients, sedated after neurosurgical operations and without signs of brainstem or cervical spinal cord dysfunction, subcortical SEP were recorded from nasopharynx (Pgz) and neck after stimulation of median and tibial nerves. Generally, a midfrontal reference (Fz) was used; in four cases, evoked potentials were additionally recorded against a non-cephalic reference. The main feature in Pgz-Fz recordings was a negative wave corresponding to the N13 (N30) component in neck derivations after stimulation of median (tibial) nerve. This wave is interpreted as reflection of medial lemniscal activity; so Pgz-Fz derivations make possible the isolated recording of the subcomponent N13b (medial lemniscus, or cuneate nucleus), without overlap with N13a (dorsal horn) - as do neck-to-scalp recordings-; and without the considerable artifacts known from farfield recordings. This interpretation is confirmed by SEP recordings in a brain death patient, showing a clear N13 component in neck-to-scalp derivations while lacking any negative wave at Pgz-Fz. In Pgz recordings against a non-cephalic reference, the P9 and P11 components (corresponding to the well known scalp farfield potentials) were clearly seen, whereas the P14 component was of low amplitude in three cases and lacking at all in one case. In conclusion, nasopharyngeal electrodes provide a useful tool in subcortical SEP recording; due to their position medio-ventrally to the lower brainstem, they complete standard electrode montages giving further informations about generator dipole location.

UI MeSH Term Description Entries
D006993 Hypnotics and Sedatives Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety. Hypnotic,Sedative,Sedative and Hypnotic,Sedatives,Hypnotic Effect,Hypnotic Effects,Hypnotics,Sedative Effect,Sedative Effects,Sedatives and Hypnotics,Effect, Hypnotic,Effect, Sedative,Effects, Hypnotic,Effects, Sedative,Hypnotic and Sedative
D008475 Median Nerve A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. Median Nerves,Nerve, Median,Nerves, Median
D008874 Midazolam A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH. Dormicum,Midazolam Hydrochloride,Midazolam Maleate,Ro 21-3981,Versed,Hydrochloride, Midazolam,Maleate, Midazolam,Ro 21 3981,Ro 213981
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009305 Nasopharynx The top portion of the pharynx situated posterior to the nose and superior to the SOFT PALATE. The nasopharynx is the posterior extension of the nasal cavities and has a respiratory function. Rhinopharynx,Choanae,Nasopharynges,Nasopharynxes,Rhinopharynges,Rhinopharynxes
D004566 Electrodes Electric conductors through which electric currents enter or leave a medium, whether it be an electrolytic solution, solid, molten mass, gas, or vacuum. Anode,Anode Materials,Cathode,Cathode Materials,Anode Material,Anodes,Cathode Material,Cathodes,Electrode,Material, Anode,Material, Cathode
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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