Somatosensory Evoked Responses in the Diagnosis of Thoracic Outlet Syndrome

A study was made of 11 patients with cervical rib, and one patient with Klippel-Fiel syndrome and enlarged transverse processes to determine whether evoked potentials recorded from both Erb's points and the cervical spine in response to median and ulnar nerve stimulation provided information additional to that obtained by EMG and peripheral conduction studies. It was found that in seven patients who had pain and paraesthesias but no objective neurological signs both the peripheral and central conduction studies were within normal limits. By contrast, of five patients who had objective signs, conventional EMG and conduction studies were abnormal in three patients, but abnormalities of the evoked potentials obtained from ulnar nerve stimulation were obtained in all five patients. It is suggested that this application of evoked potential estimation is a useful addition to the more conventional peripheral investigations.