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Early somatosensory potentials evoked by median nerve stimulation

Intraoperative monitoring

Department of Neurology (Drs) Lesser and Lueders and Mr Klem and Neurosurgery (Dr. Hahn), Cleveland Clinic Foundation, Cleveland, OH.

Address correspondence and reprint requests to Dr Lesser, Department of Neurology. Cleveland Clinic Hospital, Cleveland, OH 44106.

we identified the sites of origin of the somatosensory evoked potentials to median nerve stimulation by recording directly from the cervical cord in the course of intraoperative monitoring. The N9 potential occurred before any potentials recorded from the cord or dorsal roots. Potentials with latencies corresponding to N11 were recorded at the median nerve root entry zone of the lower cervical cord. High-amplitude potentials were recorded at the level of the foramen magnum, with latencies approximating or following P13, suggesting that this potential is generated at the cervicomedullary junction.