Esophageal sensation in spinal cord-injured patients: balloon distension and cerebral evoked potential recording

Abstract

We sought to determine the esophageal sensory function in patients with a C6 or C7 spinal cord injury. A balloon was repetitively distended 10 cm above the lower esophageal sphincter in five patients and nine normal control subjects. Sensation was reported on a scale from 0 to 2 with progressive distension to pain threshold (level 2). Cortical responses were recorded from midline scalp electrodes. Blinded determinations of quality and reproducibility of the potentials were performed. All subjects experienced sensation with esophageal balloon distension. Volumes to sensation showed a trend toward a higher sensory threshold in patients but were significant only for first sensation, not pain. In all subjects, a triphasic evoked potential response consisting of a negative-positive-negative complex was noted with distension but not with sham distension. Characteristics (amplitude, latency, reproducibility, and quality) of the evoked potentials were not different in patient and control groups. These data suggest sensory pathways from the distal esophagus are intact in patients with a C6 or C7 spinal cord injury.