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Neuropediatrics 1997; 28(3): 168-174
DOI: 10.1055/s-2007-973695
Original articles

© Hippokrates Verlag GmbH Stuttgart

Mechanisms of Central Motor Reorganization in Pediatric Hemiplegic Patients

Y. Maegaki1 , Y. Maeoka1 , S. Ishii2 , M. Shiota3 , A. Takeuchi3 , K. Yoshino4 , K. Takeshita1
  • 1Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University,
  • 2Department of Pediatrics, Eastern Shimane Rehabilitation Center for Handicaps,
  • 3Division of Child Neurology, Tottori Prefectural Kaike Rehabilitation Center for Disabled Children,
  • 4Department of Pediatrics, National Nishitottori Hospital, Japan
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Publication History

Publication Date:
13 March 2007 (online)

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Abstract

Twenty hemipiegic patients were studied with transcranial magnetic stimulation (TMS). Motor evoked potentials (MEPs) of the biceps brachii (BB) and the abductor pollicis brevis muscles (APB) were recorded on both sides simultaneously. TMS was carried out with an 8-shaped coil over different scalp positions in the intact hemisphere. Bilateral MEPs of BB were elicited in patients with later childhood lesion as well as early lesion, but those of APB were only elicited in the latter (up to 2 years). In patients with prenatal or birth lesion on BB and in all patients on APB, cortical maps of MEP amplitude of paretic and non-paretic sides showed similar distributions. There were no remarkable differences in mean latency between both sides, and correlation coefficients of MEP amplitude between both sides were high in these patients. In patients with postnatal lesion on BB, MEP maps of both sides showed different distributions, ipsilateral MEP latencies were delayed and correlation coefficients were low. We suspect that ipsilateral MEPs after early lesion derive from axonal sprouting both in the proximal and the distal muscles. After postnatal lesion, other mechanisms of ipsilateral motor projection take place in the proximal muscles, but not in the distal ones.

Key words

Plasticity - Hemiplegia - Children - Magnetic stimulation

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