CHANGES OF SENSORY AND SOMATOSENSORY EVOKED POTENTIALS FOLLOWING A NEEDLE INJURY ON THE INFERIOR ALVEOLAR NERVE IN RATS

백서 하치조 신경 손상에 따른 감각 유발전위와 체성감각 유발전위의 변화에 관한 연구

Dysfunction of the inferior alveolar nerve may result from trauma, diseases or iatrogenic injury. The development and refinement of an objective method to evaluate this clinical problem is highly desirable and needed, especially concerning for an increasing medico-legal issue. Evoked potential techniques have attracted considerable attention as a means of assessing the function and integrity of nerve pathways. The purpose of this study was to characterize the Sensory Evoked Potentials(SEPs) and Somatosensory Evoked Potentials(SSEPs) elicited by electrical stimulation of mental nerve. SEPs and SSEPs were measured and analyzed statistically before and after needle injury on the inferior alveolar nerve of Sprague-Dawalye rats. Measuring SEPs was more sensitive in evaluation of the recovery of sensory function from inferior alveolar nerve injury then measuring SSEPs but we measured SSEPs in the hope of providing a safe, simple and objective test to check oral and facial sensibility, which is acceptable to the patient. We stimulated mental nerve after needle injury on the inferior alveolar nerve and SEPS on the level of mandibular foramen and SSEPs on the level of cerebral cortex were recorded. Threshold, amplitude, and latency of both of SEPs and SSEPs were analyzed. The results were as follows ; 1. Threshold of SEPs and SSEPs were $184{\pm}14{\mu}A$ and $164{\pm}14{\mu}A$ respectively. 2 SEPs were composed of 2 waves, i.e., N1 N2 in which N1 was conducted by II fibers and N2 was conducted by III fibers. 3. SSEPS were composed of 5 waves, of which N1 and N2 shower statistically significant changes(p<0.01, unpaired t-test). 4. SEPs and SSEPs were observed to be abolished immediately after local anesthesia and recovered 30 minutes later. 5. SEPs were abolished immediately after injury. N1 of SSEPs was abolished immediately and amplitued of N2 was decreased($20.7{\pm}12.2%$) immediately after 23G needle injury, but N3, N4 and N5 did not change significantly. Recovery of waveform delayed 30 minutes in SEPs and 45 minutes in SSEPs. 6. The degree of decrease in amplitude of SEPs and SSEPs, after 30G needle injury was smaller than those with 23G. SEPs recorded on the level of mandibular foramen were though to be reliable and useful in the assessment of the function of the inferior alveolar nerve after injury. Amplitude of SSEPs reflected the function and integrity of nerve and measuring them provided a safe, simple and abjective test to check oral and facial sensibility. These results suggest that measuring SEPs and SSEPs are meaningful methods for objective assessment in the diagnosis of nerve injury. N1 and N2 of SSEPs can be useful parameters for the evaluation of the nerve function following a needle injury.