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  • 1
    ISSN: 1432-1106
    Keywords: Magnetic brain stimulation ; Hemispherectomy ; Corticospinal tract ; Cortico-reticulospinal pathways ; Human
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Numerous clinical studies on patients after hemispherectomy (HS) have provided clear evidence that two distinct groups can be recognized on the basis of the quality of their motor functions after operation. One of these consists of cases where HS was performed after normal brain maturation, the other of patients where the removed hemisphere was damaged early in life. The post-operative motor function has been found to be much better in the latter group. In the present paper it is demonstrated that in contrast to normal subjects ipsilateral compound muscle action potentials (CMAPs) induced by magnetic stimulation of the one intact motor cortex are present in patients after HS. The amplitudes of ipsilateral CMAPs in the muscles roughly correlate with their individual residual motor capacities and show a proximo-distal gradient. In patients with early brain damage prior to HS, CMAPs had short latencies and large amplitudes, whereas in patients with later acquired brain damage prior to HS, CMAPs had long latencies and small amplitudes. It is suggested that reinforcement of the ipsilateral corticospinal pathway may be responsible for residual motor functions in patients with early brain damage, whereas in patients with later acquired brain damage cortico-reticulospinal pathways may play a dominant role in ipsilateral motor control.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1459
    Keywords: Magnetic brain stimulation ; Psychogenic weakness ; Central weakness ; Corticospinal tract function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The latencies and amplitudes of responses evoked by magnetic brain stimulation (magnetic evoked potentials, MEP) in the first dorsal interosseus and the anterior tibial (TA) muscles were investigated in 15 patients with psychogenic limb weakness and in 50 patients with limb weakness due to established organic central nervous system disease. Of the patients with psychogenic limb weakness, 3 presented with upper limb monopareses, 2 with lower limb monoparesis, 4 with hemipareses, 4 with parapareses and 2 with paraparesis. All patients with psychogenic weakness had MEP in arm and leg muscles with latencies within the normal range. MEP amplitudes were also normal except for 1 patient in whom the response amplitude in the TA of the plegic limb was reduced. In patients with limb weakness due to established organic disease, MEP were frequently but not invariably abnormal. In patients with plegic (i.e. completely paretic, MRC grade 0) muscles due to organic disease, MEP always were clearly abnormal. Normal MEP were sometimes elicited from paretic muscles, more commonly in association with cerebral hemisphere lesions than with spinal lesions. We conclude that psychogenic limb weakness is associated with normal MEP. However, normal MEP in mildly paretic muscles do not definitely exclude organic pathology.
    Type of Medium: Electronic Resource
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