La maturation des potentiels evoques somesthesiques cerebraux

Cerebral somatosensory evoked potentials (SEPs) were elicited by stimulation of the median nerve and/or posterior tibial nerve in 117 children of 1 day to 16 years old. A major negative wave (N) was consistently recorded from the parietal region of the scalp when the arm was stimulated. The peak latency, the onset latency, the rising time and the duration of H wave are closely correlated with age and body length. The latencies are shortest in the subjects of 1–3 years old. SEPs to lower extremity stimulation were inconstant in the infants before the age of one. The major positive wave (P) has a variable topographic distribution along the middle line, over the scalp. The latencies are also very variable in the different subjects of the same age as well as in the same subject with different locations of active electrode. Among the parameters studied as for N wave, only the rising time of P wave is significantly correlated with age. The latencies of P wave have the shortest value in the subjects of 1–3 years old. The comparison of SEPs to upper and to lower limb stimulations shows that there is no relationship between them in respect to their morphology and amplitude. The minimum value of the latencies of N and P waves was observed at the same age but the difference between the peak latencies of P and N waves in the same subject increases considerably after 2 years of age and reaches the adult value after 5 years of age. These resultats indicate that the maturation of the peripheral somatosensory pathways proceeds at a higher rate than that of the central somatosensory pathways, that the maturation of the somatosensory pathways of the upper limb precedes that of the lower limb, and that the rising time of N or P waves is a good index of cortical maturation. The clinical utility of these SEPs in pediatrics is discussed. Les potentiels somesthésiques cérébraux (PES) évoqués par la stimulation électrique des nerfs médian et/ou tibial postérieur ont été étudiés chez 117 enfants âgés de 1 jour à 16 ans. Le PES à partir du membre supérieur est constamment retrouvé sous forme d'une onde négative (N), de topographie pariétale. Les latences du début et du sommet de cette onde, son temps de montée et sa durée, sont étroitement corrélés avec l'âge et avec la taille mais les plus courtes latences sont observées entre 1 et 3 ans. Le PES à partir du membre inférieur est inconstant chez l'enfant de moins de 1 an. C'est une onde positive (P) de topographie variable le long d