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Table of Contents
Vol. 16, No. 3, 2003
Issue release date: July 2003
Section title: Original Paper
Cerebrovasc Dis 2003;16:265–271
(DOI:10.1159/000071126)

Motor Evoked Potentials in Predicting Recovery from Upper Extremity Paralysis after Acute Stroke

Hendricks H.T.a · Pasman J.W.b · van Limbeek J.c · Zwarts M.J.b
Departments of aRehabilitation Medicine and bClinical Neurophysiology, University Medical Centre St. Radboud, and cSMK-Research, St. Maartenskliniek, Nijmegen, The Netherlands

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 23, 2002
Accepted: November 27, 2002
Published online: July 18, 2003
Issue release date: July 2003

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED

Abstract

Objective: The use of motor evoked potentials (MEPs) in predicting recovery after stroke still appears to be somehow equivocal. We assessed the prognostic value of MEPs with respect to arm and hand motor recovery in acute stroke patients. Methods: This cohort study included 43 consecutive acute stroke patients with complete paralysis of the upper extremity. MEPs of the abductor digiti minimi muscle (ADM) and the biceps brachii muscle (BB) were obtained within 10 days after stroke onset. The upper limb subset of the Fugl-Meyer Motor Assessment was used to evaluate the motor performance at regular intervals until 6 months after stroke. Results: The follow-up was complete in 40 patients (2 patients died and 1 patient had a recurrent stroke); 14 patients showed motor recovery of the arm and their mean 26-week arm motor score was 17.93 (range 3–30, SD 11.68); hand motor recovery occurred in 11 patients and their mean 26-week hand motor score was 11.09 (range 4–14, SD 4.10). Stepwise logistic regression revealed prognostic models for both arm and hand motor recovery based on BB MEPs (odds ratio 7.69, confidence interval, CI, 1.16–50.95) and ADM MEPs (odds ratio 16.20, CI 2.51–104.40), respectively. Conclusions: The predictive significance of MEPs with respect to motor recovery of the upper extremity was obvious in our homogeneous sample of patients. This agrees with the paradigm that motor recovery after infarction is strongly dependent on a critical residual sparing of the corticospinal function. In this context, the test properties of MEPs in predicting motor recovery are discussed. The added value of MEPs with respect to motor recovery of the upper extremity should be regarded as established for patients with initial paralysis, especially since clinical examination alone lacks the possibility to detect the potential for motor recovery in these cases.

© 2003 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: April 23, 2002
Accepted: November 27, 2002
Published online: July 18, 2003
Issue release date: July 2003

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 5

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: http://www.karger.com/CED


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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