Name of the Procedure:

Short-latency somatosensory evoked potential (SSEP) study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs.

Summary

A Short-latency Somatosensory Evoked Potential (SSEP) study measures the electrical responses from the nervous system following stimulation of the skin or peripheral nerves in the lower limbs. This involves small electric pulses to the nerves in the legs, with responses recorded from the brain and spinal cord.

Purpose

The SSEP study evaluates the integrity and functionality of the pathways from the peripheral nerves in the lower limbs to the central nervous system. The main goal is to identify any nerve damage or dysfunction, which can help in diagnosing and monitoring conditions affecting the nervous system.

Indications

• Diagnosing Multiple Sclerosis (MS)
• Evaluating the extent of spinal cord injuries
• Monitoring neurological functions during spine surgeries
• Assessing nerve damage due to diabetes or other peripheral neuropathies
• Determining the presence of conditions like myelopathy or radiculopathy

Preparation

• You may be asked to avoid caffeine or other stimulants for a few hours before the test.
• Wear comfortable clothing as you may need to change into a hospital gown.
• Notify your doctor of any medications you are taking, but in most cases, regular medications need not be adjusted.

• No fasting or extensive preparation is usually required.

  Procedure Description

  1. Patient Positioning: You will lie down comfortably on a bed or examination table.
  2. Electrode Placement: Electrodes will be placed on the scalp, along the spine, and on the skin over the peripheral nerves in the lower limbs.
  3. Stimulation: Small electrical pulses will be delivered to the nerves in the legs through electrodes, producing mild, tingling sensations.
  4. Recording: The electrical activity generated by the nerves in response to the stimulation will be recorded by the electrodes on the scalp and spine.
  5. Analysis: These recordings will then be analyzed to assess the speed and strength of nerve signal transmission from the lower limbs to the brain.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The SSEP study is usually performed in a hospital’s neurology department or in an outpatient neurodiagnostic lab.

Personnel

• Neurologist or Neurophysiologist
• Electroneurodiagnostic Technologist (END Technologist)
• Nursing staff for patient care and assistance

Risks and Complications

• Minor discomfort or tingling at the stimulation sites.
• Very rare risk of skin irritation from electrode adhesive.
• There are no serious risks or complications associated with this non-invasive procedure.

Benefits

• Accurate assessment of nerve function in the lower extremities.
• Helps in early diagnosis and management of neurological conditions.

• Aids in planning surgical approaches and monitoring the effectiveness of treatments.

  Recovery

• You can return to your normal activities immediately after the procedure.
• There are no specific post-procedure care instructions.
• Follow-up appointments may be scheduled to discuss the results with your doctor.

Alternatives

• Electromyography (EMG) and Nerve Conduction Studies (NCS): These can also evaluate nerve and muscle function but use different techniques.
• MRI or CT scans: Useful for imaging the nervous system but do not assess nerve function directly.
• Physical examination and clinical tests: Can provide insights but are less precise than SSEP.

Patient Experience

• You may feel mild tingling or slight discomfort during the electrical stimulation.
• The procedure is generally well-tolerated and doesn’t require anesthesia.
• Any discomfort usually subsides immediately after the stimulation ends.