Article

Case report. OBJECTIVES: To identify preserved corticomotor
connection in chronic spinal cord injury (SCI) in the absence of clinically
observable movement. SETTING: Rehabilitation Hospital and Medical Research
Institute, NY, USA. METHODS: The motor-evoked potential (MEP) response to
transcranial magnetic stimulation (TMS) was recorded using surface
electromyography from the right biceps brachii, extersor carpi radialis (ECR),
flexor carpi radialis (FCR) and abductor pollicis brevis (APB) muscles in a
31-year-old male traumatic SCI chronic patient-ASIA B, injury level C5. Motor
power scores were additionally obtained from a clinician blinded to the results
of TMS. RESULTS: TMS could consistently elicit MEPs of normal latency, phase and
amplitude, in the severely affected ECR muscle but not the similarly affected FCR
muscle. The response in proximal and unaffected biceps muscle was larger than the
healthy subject, whereas no response was obtained in the distal APB muscle as expected. CONCLUSION: TMS can identify residual pathways not apparent from clinical assessment alone, which may have prescriptive value for rehabilitation.

Langue : ANGLAIS