Optimizing stimulating and recording parameters in somatosensory evoked potential studies

Methods to increase the signal:noise ratio of evoked potentials are reviewed, dividing them into three groups: (1) increasing the number of stimuli averaged; (2) decreasing the noise (muscle relaxation, filters, intermittent artifact reject methods); and (3) increasing the amplitude of the signal (stimulus intensity, nerves stimulated, bilateral versus unilateral stimulation, stimulus modality, and montage). Examples of these different methods applied to recording of somatosensory evoked potentials are given, and it is concluded that, for optimal recording of somatosensory evoked potentials, a combination of all these methods should be used.