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
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
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多脉冲磁刺激引起的运动诱发电位对手术引起的辅助运动区短暂性病变的预后价值：病例报告
DOI：
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发表时间：
2000
影响因子：
11
通讯作者：
V. Deletis
中科院分区：
文献类型：
--
作者：
Francesco Sala;M. Kržan;G. Jallo;Fred Epstein;V. Deletis
涉及辅助运动区（SMA）的手术使患者面临短暂性运动功能障碍的风险。预测术后早期运动功能减退患者的结局与患者和手术团队都相关。一个15岁的女孩与一个大的左丘脑肿瘤通过左经胼胝体的方法删除描述。尽管术中保留了多脉冲电刺激引起的所有肢体的肌肉运动诱发电位（mMEP），但患者醒来时出现右侧偏瘫和缄默症。在术后第一天，使用多脉冲磁刺激技术进行神经生理学评估，采用一系列四个磁刺激，证实了偏瘫右侧肢体存在mMEP。当天晚些时候观察到右侧肢体轻微自发运动活动和初始言语，随后几天显著改善。 得出的结论是，可能需要多个而不是单一的磁刺激技术，以引起mMEP的早期术后鉴别诊断SMA损伤与损伤的初级运动皮层或皮质脊髓束。
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.