Author/Editor		Sala, F; Kržan, MJ; Jallo, G; Epstein, FJ; Deletis, V
Title		Prognostic value of motor evoked potentials elicited by multipulse magnetic stimulation in a surgically induced transitory lesion of the supplementary motor area: a case report
Type		članek
Source		J Neurol Neurosurg Psychiatry
Vol. and No.		Letnik 69, št. 6
Publication year		2000
Volume		str. 828-31
Language		eng
Abstract		Surgery involving the supplementary motor area (SMA) places the patient at risk of transient motor deficit. To predict outcome in patients with early postoperative hypokinesis would be relevant to both the patient and the surgical team. A 15 year old girl with a large left thalamic tumour removed through a left transcallosal approach is described. Despite intraoperatively preserved muscle motor evoked potentials (mMEPs) from all limbs, elicited by multipulse electrical stimulation, she awoke with a right hemiplegia and mutism. On the first postoperative day, neurophysiological evaluation using a multipulse magnetic stimulation technique, with a train of four magnetic stimuli, confirmed the presence of mMEPs from the hemiplegic right limbs. Slight spontaneous motor activity of the right limbs and initial speech were seen later on the same day with dramatic improvement over subsequent days. It is concluded that multiple rather than single magnetic stimulation techniques may be needed to elicit mMEPs for an early postoperative differential diagnosis of SMA damage versus injury to the primary motor cortex or the corticospinal tract.
Descriptors		BRAIN DISEASES EVOKED POTENTIALS, MOTOR MOTOR CORTEX CHILD PROGNOSIS MAGNETIC RESONANCE IMAGING