Brainstem Auditory and Somatosensory Evoked Potentials in Relation to Clinical and Neuroimaging Findings in Chiari Type 1 Malformation

PURPOSE:The aim of this study was to describe the abnormalities found in the recordings of evoked potentials (EPs), in particular those of brainstem auditory evoked potentials and somatosensory evoked potentials, in a homogeneous series of patients with Chiari type 1 malformation (CM-1) and study their relationship with clinical symptoms and malformation severity. CM-1 is characterized by cerebellar tonsils that descend below the foramen magnum and may be associated with EP alterations. However, only a small number of authors have described these tests in CM-1, and the patient groups studied to date have been small and heterogeneous. METHODS:The clinical findings, neuroimages, and EP findings were retrospectively studied in a cohort of 50 patients with CM-1. RESULTS:Seventy percent of patients had EP abnormalities (brainstem auditory evoked potential52%, posterior tibial nerve somatosensory evoked potential42%, and median nerve somatosensory evoked potential34%). The most frequent alteration was an increased central conduction time. Morphometric measurements differed between the normal and pathological groups, although no statistical significance was found when comparing these groups. CONCLUSIONS:A high percentage of patients with CM-1 show EP alterations regardless of their clinical or radiological findings, thus highlighting the necessity of performing these tests, especially in patients with few or no symptoms.