EVOKED-POTENTIAL ABNORMALITIES IN POSTOPERATIVE-PATIENTS WITH BILIARYATRESIA

The somatosensory evoked potentials from the lower extremities mere me asured postoperatively in 15 patients with biliary atresia to investig ate whether they were free of neurologic dysfunction, Because longstan ding cholestasis causes progressive neuropathy due to malabsorption of vitamin E, the serum vitamin E, D, and A levels were also examined to evaluate the fat-soluble vitamin status, The cerebral evoked potentia ls to posterior tibial nerve stimulation were recorded in all 15 patie nts as well as in 45 controls, but spinal evoked potentials examined a t the level of the cauda equina could not be recorded in five patients more than 8 years of age with long-standing icterus, The remaining 10 patients exhibited spinal evoked potentials as observed in the contro ls, but the mean neural conduction velocity at the cauda equina was si gnificantly lower than that of the 45 controls (42.0 +/- 5.1 m/s vs 52 .3 +/- 6.5 m/s, P = .0002), The serum vitamin E, D, and A levels were within the normal range in 13, 9, and 1 of 15 patients, respectively. These results suggest that the patients with long-term follow-up are s till at risk of developing neural disturbances even with normal serum vitamin E status. (C) 1997 by Elsevier Science Inc.