Early motor evoked potentials in acute stroke: adjunctive measure to MRI for assessment of prognosis in acute stroke within 6 hours

Cerebrovascular Diseases
Johannes C WöhrleMichael G Hennerici

Abstract

In acute stroke, a magnetic resonance (MR) perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) mismatch (PWI>DWI mismatch) may indicate tissue at risk for infarction and poor prognosis. However, different to early enthusiasm about this surrogate marker, its validity has shown several drawbacks in individual patients. Rather than relying on imaging, we evaluated motor evoked potentials (MEP) as a measure of cerebral function in the acute stroke setting. Thirteen patients with acute hemiparetic stroke underwent time to peak PWI and DWI within 6 h after onset as well as recordings of early MEP of first dorsal interosseous muscles. Outcome was assessed by the Unified Neurological Stroke Scale and Barthel Index at day 42. Of 8 patients with PWI>DWI mismatch, 4 patients with normal MEP had a good clinical outcome and 4 patients with absent or pathological MEP had an unfavourable outcome (p < 0.05, Fisher's exact test). In all patients without PWI>DWI mismatch, MEP findings predicted clinical outcome. Normal MEP at day 0--but not PWI/DWI findings--significantly correlated with a good clinical outcome. Early MEP recordings in acute stroke patients provide valid prognostic information; they may become more useful for s...Continue Reading

References

Dec 14, 1995·The New England Journal of Medicine·UNKNOWN National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group
Nov 1, 1994·Stroke; a Journal of Cerebral Circulation·N AraçC Ertekin
Dec 1, 1996·Stroke; a Journal of Cerebral Circulation·G RapisardaP J Delwaide
Nov 14, 1997·Journal of Neurology·U K Misra, J Kalita
Jan 5, 1999·Cerebrovascular Diseases·M De GeorgiaL Caplan
Aug 6, 1999·Stroke; a Journal of Cerebral Circulation·T Neumann-HaefelinH J Freund
Jan 6, 2000·Journal of the Neurological Sciences·S SchwarzS Schwab
Jun 3, 2000·Stroke; a Journal of Cerebral Circulation·T Neumann-HaefelinH J Freund
Aug 30, 2000·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·R TraversaP M Rossini
Oct 6, 2000·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·C TrompettoG Abbruzzese
Nov 30, 2000·Cerebrovascular Diseases·M Hennerici, S Meairs
Jan 10, 2002·Stroke; a Journal of Cerebral Circulation·Jens FiehlerJoachim Röther
Jan 10, 2002·Annals of Neurology·Mark W ParsonsStephen M Davis
Oct 31, 2002·Cerebrovascular Diseases·Jens FiehlerJoachim Röther
Jul 17, 2003·Cerebrovascular Diseases·Henk T HendricksMachiel J Zwarts

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Citations

Nov 12, 2005·Cerebrovascular Diseases·Stefan H KreiselMichael G Hennerici
Sep 14, 2012·Neuropsychiatric Disease and Treatment·Kianoush Fathi VajargahMehdi Farhoudi
Aug 10, 2016·Neurorehabilitation and Neural Repair·Bokkyu Kim, Carolee Winstein
Sep 28, 2015·Restorative Neurology and Neuroscience·Maddalena BrunettiChristian Dohle

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