P41-F Reliability of BAEP, MEP and blink reflex (BR) combination in posterior circulation ischemic stroke

Background CTAG examination as a “gold standard” in acute phase of stroke in vertebrobasilar region is often inconclusive. The aim of our study is to evaluate the sensitivity and specificity of neurophysiological methods - BAEP, MEP ad blink reflex (BR) - and comparison with imaging methods (DWI) results. Methods Group of 20 patients with clinical suspicion of acute ischemic stroke in vertebrobasilar region were evaluated from April to December 2018. The average time between onset of stroke and neurophysiological examination was 4,35 day. The patients with history of previous stroke and with the CT signs of acute supratentorial stroke were excluded. A combination of three electrophysiological methods (Blink reflex, MEP and BAEP) were used. Time of electrophysiological examination didn’t exceed 30 min. In all patients was also DWI performed. Electrophysiological abnormity patterns were correlated with the clinical presentation and with the DWI findings. Results MEP abnormality (unilateral significant central motor latency prolongation) was observed in 6/20 patients. BAEP central abnormality (prolongation of wave III-V latency) was detected in only 4/20 patients. Blink reflex abnormality was found in 14/20 patients: In 1 case early response latency prolongation, other abnormalities were related to late responses. 6× observed we typical pattern of R2 and R2c prolongation/missing while stimulating on the site of damage. We assume abnormal electrophysiological test can help to indicate patients with a normal CTAG to DWI. There is a need for a larger group of patients to generalize the results.