Comprehensive Diagnostics of Impaired Pathway Functions at Various Levels of the Central and Peripheral Nervous System in Children

Multipurpose diagnostics of disorders of the conductive functions of the central and peripheral nervous system at various levels is extremely important.

Objective: To study the possibilities of diagnostic transcranial magnetic stimulation (TKMS), and somatosensory evoked potentials of (SSEP) in the diagnosis of disorders of the pathways of the central and peripheral nervous system

Methods: We carried out an initial and final examination of 86 children aged 5 to 12 years with the consequences of perinatal hypoxic-ischemic focal lesions of the central nervous system in the left hemisphere of the brain.

The efferent conduction was diagnosed using the TKMS method using on a magnetic stimulator Neuro-MS/D Neurosoft (1.5 Tesla). The cortical representation of the distal muscles of the upper limbs and the roots of the cervical plexus was tested. Registration of answers was made with m. abd. pollicis brevis. The survey identified a group of 30 patients in whom the TKMS data corresponded to the degree of paresis.

Results: Analysis of pairwise differences between measurements before and after the rehabilitation period, adjusted for multiple comparisons, showed changes in the TCMC indicators: VSMC, LatKVMO (in the right and left hemisphere), PS% (in the right hemisphere), and duration of the CVMO (in the left hemisphere); and SSEP: inter-peak latency N20 / P23 (in the right and left hemisphere) (F values of the criterion from 4.4 to 9.52, p <0.01).

Inter-peak latency N20 / P23 in the right hemisphere also negatively correlates with PS% in the left hemisphere (-0.377, p = 0.015), N20 / P23 in the left hemisphere - c AsVMO in the left hemisphere (-0.386, p = 0.0 13).

Conclusion: application integrated bidirectional diagnostics based on the use of TKMS and SSVP methods makes it possible to objectify the violation of the functions of the pathways at various levels of nervous systems.