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Imagine, then, that you have a friend who has been happily using Windows XP Professional for a few years, but now wants to upgrade to Vista His PC isn t the very latest and greatest, but it s still pretty respectable Before you agree to upgrade the OS, you want to make sure that his system meets the Vista requirements You also have been thinking about nally upgrading your own XP system, so you head to Microsoft s Web site to do some research

of nerve will be diluted by the necessary inclusion of long segments of normally conducting nerve in the test response Additionally, unlike nerve conductions where normative data relate to latency measurements over precisely measured segments of nerve, latency measurements in SEPs are very much in uenced by the variability of leg length Although the opposite side can be used as comparison, the potential for bilateral involvement diminishes the utility of this strategy Even if axon loss occurs, interpretation may remain dif cult Axon loss determination in sensory nerve bers is implied by loss of waveform amplitude; SEPs share another shortcoming with F-wave determinations, ie, amplitude measurements are not reliable Additionally, SEPs are commonly elicited by stimulating peripheral nerve trunks As the majority of nerves, eg, the common peroneal, contain bers from multiple dermatomes, axon loss of a single root is usually accompanied by normal SEP results6,22,23 This is presumably the result of an incomplete lesion or the contributions from other unaffected roots In an attempt to overcome problems inherent in stimulating nerve trunks to detect monoradiculopathies, SEPs obtained by cutaneous nerve or dermatomal stimulation has been attempted Reports regarding these techniques have provided disparate conclusions In general, it is probably accurate to suggest that SEPs done by any technique have a limited role to play in the evaluation of a patient with suspected radiculopathy Motor-evoked potentials may be recorded from muscles in response to electrical stimulation of nerve roots, or magnetic stimulation of nerve root or motor cortex The problems associated with the performance and interpretation of electrical stimulation nerve roots are elaborated upon in 2 In general, none of these techniques appear to be easy enough to perform or adequately accurate or reproducible enough to warrant their routine use in clinical practice6 The current gold standard for the evaluation of patients with suspected monoradiculopathies of the lower extremities remains anchored to the clinical evaluation supplemented by imaging and/or conventional EDX The primary goal in developing new testing methodologies is to improve upon the imperfection of current methodologies Unfortunately, without sensitivities and speci cities that reproducibly approach the existing gold standard, con dence in the signi cance of an isolated test result in any newer testing method must be viewed with suspicion.

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Rational management of lumbosacral monoradiculopathies requires an understanding of the natural history of the disease As mentioned in the previous section, the patient with an unambiguous presentation of a monoradiculopathy can be followed clinically without

Figure 7-1

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To review the operating systems offered by Microsoft, including Vista, refer to the Microsoft Windows section in 12 of Mike Meyers A+ Guide to Managing and Troubleshooting PCs

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