Electrophysiological recordings in patients with spinal cord injury: significance for predicting outcome

The clinical assessment of the level, extent and severity of spinal cord in jury (SCI) can be supplemented by electrophysiological recordings. These te chniques also provide an early diagnosis of neurological deficits in patien ts with acute SCI and are of prognostic value even in uncooperative patient s. Electrophysiological recordings (motor evoked potentials (MEP) and somat o-sensory evoked potentials (SSEP)) are of similar significance in predicti ng functional outcome of ambulatory capacity, hand- and bladder function as the clinical examination according to the ASIA standards. EMG, neurographi c and reflex recordings of acute SCI patients within spinal shock are even more sensitive in assessing an associated damage of the peripheral motor pa thways tie of motoneurones and nerve roots) than the clinical examination a nd allow the possibility of predicting the development of muscle tone or mu scle atrophy. The evaluation of impairment of the autonomic nervous system after SCI by clinical examination is restricted. In contrast, recordings of the sympathetic skin response (SSR) can provide information about the exte nt and level of lesions of the spinal sympathetic nervous system which are related to autonomic dysfunction. Therefore, electrophysiological recording s supplementary to the clinical examination are helpful for planning and se lecting the appropriate therapeutical approaches within the rehabilitation programme. Furthermore, they allow the prediction of functional outcome and the objective assessment of recovery of specific parts of the spinal and p eripheral fibre tracts.