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KMID : 0377519970220020095
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Chung-Ang Journal of Medicine
1997 Volume.22 No. 2 p.95 ~ p.107
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Evaluation on themotor evoked potentials in the normal subjects and stroke patients
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Kim Dong-Hyun
Park Chong-Won
Kwon Oh-Sang
Kim Doo-Eung
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Abstract
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Since the development of magnetic stimulation as a way of assessing the function of central motor pathways, various neurologic diseases have been investigated by motor evoked potentials(MEP). This study was carried out to evaluate the usefulness of clinical application of MEP to the stroke patients. MEP were elicited with transcranial cortical stimulation using a magnetic coil in 21 healthy subjects and 18 stroke patients. Average of age was 37.5±18.0 and 63.7±7.7 years in normal and patient groups respectively. All stroke patients had a mild to severe clinical unilateral motor weakness, and also were proven to have unilateral infarction or hemorrhage at various regions of brain radiologically. During MEP studies, neither significant side effects nor pin were encountered. MEP latency of abductor pollicis brevis(APB) and extensor digitorum brevis(EDB) in controls measured 22.4±2.0 msec and 41.8±2.9 msec respectively. Normal central motor conduction time(CMCT) was 9.7±1.6 msec and 19.3±2.3 msec respectively. The amplitudes of MEP were not reliable due to great variability. Abnormal responses were noted in 5 patients on the APB and in 12 patients on the EDB motor evoked potentieal studies. Mean latency and CMCT were significantly prolonged in involved sites of the other 16 patients, comparing with control data. Prolonged latency and CMCT, increased inter-side difference of CMCT. Any potential was not a useful indicator in determining abnormality of MEP study. More paralyzed patients were apt to show abnormal responses in MEP studies. There were also more abnormal results during acute stage compared with chronic stage More abnormal results were observed in the patients with cerebral cortex or corona radiata involvements. It is suggested that MEP study is a useful and sensitive method in the evaluation of stroke patients and be a effective method for further understanding of central motor system.
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KEYWORD
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Motor evoked potential, central motor conduction time, stroke
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