We reported a 48-year-old man with Behcet disease, who presented with right hemiparesis. His first brain MRI showed multiple enhanced lesions. During the recovery, he had an episode of left 6th nerve palsy without new lesions in a follow-up MRI. Third episode was cervical myelitis, resulting in respiratory difficulty and quadriplegia without any reflexes. The myelitis was not responsive to immunotherapy. He died of respiratory failure complicated with pneumonia. This is a rare case of full-blown neuro-Behcet disease.
Brain stem auditory evoked potential(BAEP) is a useful study to evaluate the integrity of auditory system particularly from cochlear nerve up to brain stem. This review article will provide the basic protocol settings necessary for collecting routine BAEP procedures for the neurological diseases. Also, basic knowledge necessary for the understanding and interpretation of the BAEP responses will be discussed.
Background Idiopathic Parkinson's disease (IPD) is closely related to Lewy body pathology. Pathological changes in medullar oblongata and pontine tegmentum have been reported in patients with subclinical motor symptom. Vestibular evoked myogenic potential (VEMP) is mediated by vestibular nuclei in lower brainstem and reflects the function of lower brainstem. The purpose of our study is to estimate the lower brainstem function in IPD patients.M e t h o d s: Ten patients with idiopathic Parkinson's disease underwent VEMP test. The patients were divided into Hohn-Yahr (H-Y) stage I (unilateral motor involvement) group and H-Y stage II or more severe (bilateral motor involvement) group. VEMP results were compared between groups using Mann-Whitney U test.R e s u l t s: Among patients, 6 patients showed abnormal VEMP (unilateral abnormality 2, bilateral abnormalities 4). Between H-Y stage I group and H-Y II,III group, there was no statistical difference in the results of VEMP.Conclusions: We concluded that the lower brainstem dysfunction reflected in VEMP could occur in IPD regardless of the progression of the disease.
Intraoperative neuromonitoring (INM) is well known to be useful method to reduce intraoperative complications during the surgery of nervous system lesions. Evoked potentials are most commonly used among the electrophysiological tests. Brainstem auditory evoked potentials are for detecting the problems along the auditory pathways including the eighth cranial nerve and brainstem. Somatosensory evoked potentials are applied for preventing the spinal cord lesions. The INM is affected by many factors. In order to perform an optimal INM, the confounding factors including technical, anesthetical, and individual factors should be kept well under control. INM has frequent electrophysiologic changes during the surgery and it might be helpful to keep one
Various electrophysiological tests have provided a large body of valuable information on neuronal responses to a presentedstimulus. The special and general somatic sensory pathways are main targets of evoked potentials. Two types of evokedpotentials, exogenous and endogenous, are commonly used. Exogenous evoked potentials of general and special somatic sensorysystems will be reviewed. One of general somatic sensory functional pathways, proprioception, can be evaluated by generalsomatosensory evoked potentials with electrical stimulation on nerves. The special somatosensory functional pathways,including vision, and audition, can be evaluated by visual evoked potentials and auditory evoked potentials. Also laser-evokedpotentials are newly developed for pain pathway, including lateral spinothalamic pathway, and vestibular myogenic evokedpotentials for sacculocollic pathways. The evoked potentials of sensory system have maximal clinical utility in evaluatingfunctional deficits along the sensory pathways. They are used for evaluating comatose patients, hysterical patients, prematureinfants, patients with suspected demyelinating diseases or neoplasms, and research. We discuss the neurophysiologic testsof sensory systems in views of practical points. The organized evaluation of sensory electrophysiologic tests can be helpfulin detecting and estimating the abnormalities in neurological diseases.