How do somatosensory evoked potentials (SEPs) findings in children differ from adults?

Updated: Feb 26, 2019
  • Author: Sombat Muengtaweepongsa, MD, MSc; Chief Editor: Selim R Benbadis, MD  more...
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The cortical SEP to posterior tibial nerve stimulation may be absent in healthy infants as old as 3 months. The cortical SEP to median nerve stimulation also may be absent at birth but most likely is present consistently in healthy infants at an earlier age than the corresponding component of the lower limb SEP. SEP component latencies are, in general, shorter in infants and children than in adults and change progressively with growth and maturation. The latency changes predominantly reflect linear growth with elongation of the peripheral nerves and central somatosensory pathways. These effects are counterbalanced partially by myelination and increase in the fiber diameters, which produce faster conduction velocities, and partially by maturation of synaptic transmission. The latter effects operate until age 6-8 years, at which time central conduction times have reached adult levels and further latency changes are due to changes in stature. [16, 17]

During spinal surgery in children in whom cortical SEPs are absent or easily attenuated by anesthesia, the far-field SEP components may be used to monitor the dorsal column pathway of the spinal cord. However, many patients with lumbar meningomyeloceles have conduction abnormalities (eg, conduction blocks, temporal dispersion) at the level of the neural plaque so that both far-field and cortical SEPs are absent; this precludes intraoperative assessment of the dorsal column pathways in these patients.


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