Somatosensory evoked potentials in the assessment of peripheral neuropathies: Commented results of a survey among French-speaking practitioners and recommendations for practice.

BACKGROUND: Somatosensory evoked potentials (SSEPs) are increasingly performed for the assessment of peripheral neuropathies, but no practical guidelines have yet been established in this specific application. STUDY AIM: To determine the relevant indication criteria and optimal technical parameters for SSEP recording in peripheral neuropathy investigation. METHODS: A survey was conducted among the French-speaking practitioners with experience of SSEP recording in the context of peripheral neuropathies. The results of the survey were analyzed and discussed to provide recommendations for practice. RESULTS: SSEPs appear to be a second-line test when electroneuromyographic investigation is not sufficiently conclusive, providing complementary and valuable information on central and proximal peripheral conduction in the somatosensory pathways. CONCLUSIONS: Guidelines for a standardized recording protocol, including the various parameters to be measured, are proposed. CLINICAL RELEVANCE: We hope that these proposals will help to recognize the value of this technique in peripheral neuropathy assessment in clinical practice.

[Acute Trypanosoma brucei gambiense meningoencephalitis detected by papillary edema]. / Méningo-encéphalite aiguë à Typanosoma brucei gambiense révélée par un oedème papillaire.

A 26 year old woman, living in Brazzaville, was referred by her ophthalmologist about papillo-oedema. Neurological examination showed frontal syndrome and papillo-oedema without another sign of intracranial hypertension. Electroencephalogram revealed bilateral delta waves and bifrontal points. Significant inflammatory syndrome was noted. Cerebrospinal fluid examination showed trypanosomes with an elevated rate of protein and cells. Treatment by tetracosactide and eflornithine gave a good recovery. Authors are stressing the disconcerting feature of this clinical form. An urban from of the disease and the fight against african trypanosomiasis are also discussed.