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Somatosensory evoked potentials (SEP) are attenuated following double electrical stimulation of the fingers (II + III). This effect is observed at cervical (N13), parietal (N20-P27) and frontal (P22-N30) levels. We simultaneously observed in the same subjects that cutaneous perception of the test-shock is completely suppressed with interstimulus intervals (ISI) within a 0-10 msec range. With 25-30 msec ISI, the perceptive function totally recovers, but SEP inhibition remains at 50 % of the control. The SEP reduction does not result in a perception deficit as long as the cortical-test response exceeds 50% of control. These results suggest that: SEP inhibition could be a local but durable phenomenon occurring at both cervical and cortical levels. Cutaneous perception does not necessitate a maximal SEP development. The perceptive process involves other associative areas (5,7...) and is activated when the primary cortical activation exceeds a certain threshold which was found at 50% of the unconditioned response voltage.

In a revision of 473 spina Bifida cystica, 19 lumbosacral lipomas during the last 13 years is presented. It corresponds to a 4,01% of total cases. The results are commented pointing out the embryology, symptomatology and diagnostic. The treatment is surgical before symptomatology appear. It is very important early surgery for the risk is very low if we compare it with the serious neurologic symptoms that can be established. Tumor must be exirpated as much as possible, liberalizing the medullar adherences that avoid its free ascend. All surgical cases presented an intramedullar communication and compresion. Only three of them, under 3 months of life, are not operated. Postsurgery evolution is satisfactory.

SEPs have been recorded in 15 patients with spinal cord tumors (mostly ependymomas) and in 5 patients with cord compression due to meningiomas (3 cas), neuromas (1 case) or neurosarcoma (1 cas). All the patients have been operated on so that precise informations were available on the histology and the location of the tumor. SEPs were monitored during surgery in 8 patients. The main conclusions of this study are as follows: There was a good correlation between the somatosensory troubles for touch, vibration sense and joint position sense, and SEPs abnormalities, however, SEPs may be clearly abnormal in the absence of any somatosensory deficit when the dorsal columns are compressed and not infiltrated by the tumor. In the latter situation the reverse dissociation (i.e., normal SEPs with somatosensory troubles) may be observed. The possibility of a dissociation between normal N11 and N13 cervical components and absent P14 far field components (non-cephalic reference) has been confirmed in 6 patients with cervicomedullary tumors. In 3 of them, this dissociation was found to be reversible and early SEPs returned to normal after surgery. Peroperative monitoring of scalp SEPs recorded with a non-cephalic reference electrode allowed the detection of transient SEP abnormalities related with a traction on the dorsal columns of the cord. SEP monitoring is recommended for any surgical removal of tumor that needs a posterior myelotomy.