The MEP in clinical neurodiagnosis

2012 ◽  
Author(s):  
Friedhelm Sandbrink
Keyword(s):  
Motor Neuron ◽  
Neurological Disorders ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Motor Neuron Diseases ◽  
Motor Pathway ◽  
Pathway Function ◽  
Transcranial Electric Stimulation ◽  
Lumbar Spinal ◽  
Stimulation Of

This article gives information on the clinical application of motor-evoked potential (MEP). Transcranial stimulation of the cerebral cortex to elicit MEPs is a noninvasive method for assessing the integrity of the central motor pathway function. Transcranial magnetic stimulation (TMS) is used in diagnosing and monitoring neurological disorders. This article highlights the neurophysiological differences between TMS and transcranial electric stimulation. All the different MEP parameters that can be measured by TMS, the latency of the MEP is generally regarded as the most reliable and useful. TMS studies have been described in many neurological disorders. The sensitivity of TMS in detecting subclinical upper motor neuron lesion varies in different disorders, depending on number of muscles and different parameters used. This article talks about the application of MEP in pathophysiology, multiple sclerosis, motor neuron diseases, meyloptahy, cerebral infarction, movement disorders, epilepsy, Lumbar spinal stenosis and radiculopathies, peripheral nerve disorders etc.

scholarly journals Motor-Evoked Potential Confirmation of Functional Improvement by Transplanted Bone Marrow Mesenchymal Stem Cell in the Ischemic Rat Brain

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Dong-Kyu Jang ◽  
Sang-In Park ◽  
Young-Min Han ◽  
Kyung-Sool Jang ◽  
Moon-Seo Park ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Rat Brain ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Functional Improvement ◽  
Control Group ◽  
Motor Pathway ◽  
Bipolar Stimulation ◽  
Marrow Mesenchymal Stem Cells ◽  
Monopolar Stimulation

This study investigated the effect of bone marrow mesenchymal stem cells (BMSCs) on the motor pathway in the transient ischemic rat brain that were transplanted through the carotid artery, measuring motor-evoked potential (MEP) in the four limbs muscle and the atlantooccipital membrane, which was elicited after monopolar and bipolar transcortical stimulation. After monopolar stimulation, the latency of MEP was significantly prolonged, and the amplitude was less reduced in the BMSC group in comparison with the control group (). MEPs induced by bipolar stimulation in the left forelimb could be measured in 40% of the BMSC group and the I wave that was not detected in the control group was also detected in 40% of the BMSC group. Our preliminary results imply that BMSCs transplanted to the ischemic rat brain mediate effects on the functional recovery of the cerebral motor cortex and the motor pathway.

scholarly journals Transcranial Electrical Motor Evoked Potential in Predicting Positive Functional Outcome of Patients after Decompressive Spine Surgery: Review on Challenges and Recommendations towards Objective Interpretation

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Mohd Redzuan Jamaludin ◽  
Khin Wee Lai ◽  
Joon Huang Chuah ◽  
Muhammad Afiq Zaki ◽  
Yan Chai Hum ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Functional Outcome ◽  
Evoked Potential ◽  
Motor Nerve ◽  
Motor Evoked Potential ◽  
Nerve Roots ◽  
Motor Pathway ◽  
Positive Functional ◽  
Prognostic Tool ◽  
Objective Interpretation

Spine surgeries impose risk to the spine’s surrounding anatomical and physiological structures especially the spinal cord and the nerve roots. Intraoperative neuromonitoring (IONM) is a technology developed to monitor the integrity of the spinal cord and the nerve roots via the surgery. Transcranial motor evoked potential (TcMEP) (one of the IONM modalities) is adopted to monitor the integrity of the motor pathway of the spinal cord and the motor nerve roots. Recent research suggested that the IONM is conducive as a prognostic tool towards the patient’s functional outcome. This paper summarizes the researches of IONM being adopted as a prognostic tool. In addition, this paper highlights the problems associated with the signal parameters as the improvement criteria in the previous researches. Lastly, we review the challenges of TcMEP to achieve a prognostic tool focusing on the factors that could interfere with the generation of a stable TcMEP response. The final section will discuss recommendations for IONM technology to achieve an objective prognostic tool.

Motor Evoked Potentials from Transcranial Stimulation of the Motor Cortex in Humans

Neurosurgery ◽  
1984 ◽  
Vol 15 (3) ◽  
pp. 287-302 ◽  
Author(s):  
Walter J. Levy ◽  
Donald H. York ◽  
Michael McCaffrey ◽  
Fred Tanzer
Keyword(s):  
Spinal Cord ◽  
Motor Cortex ◽  
Evoked Potentials ◽  
Evoked Potential ◽  
Motor Evoked Potentials ◽  
Sensory Modality ◽  
Motor Evoked Potential ◽  
Transcranial Stimulation ◽  
Direct Stimulation ◽  
Stimulation Of

Abstract Electrical monitoring of the motor system offers the potential for the detection of injury, the diagnosis of disease, the evaluation of treatment, and the prediction of recovery from damage. Existing evoked potentials monitor one or another sensory modality, but no generally usable motor monitor exists. We have reported a motor evoked potential using direct stimulation of the spinal cord over the motor tracts in cats and in humans. To achieve a less invasive monitor, we used transcranial stimulation over the motor cortex in the cat, thus stimulating the motor cortex. We report here the initial application of this method to humans. A plate electrode over the motor cortex on the scalp and a second electrode on the palate direct a mild current through the motor cortex which will activate the motor pathways. This signal can be recorded over the spinal cord. It can elicit contralateral peripheral nerve and electromyographic signals in the limbs or movements when the appropriate stimulation parameters are used. In clinical use to date, this has been more reliable than the somatosensory evoked potential in predicting motor function in patients where the two tests differed. It offers a number of possibilities for the development of valuable brain and spinal cord monitoring techinques, but requires further animal studies and clinical experience. Studies to date have not demonstrated adverse effects, but evaluation is continuing.

O181 Usefulness of transcranial motor evoked potential during surgery for gliomas located close to the motor pathway

2017 ◽  
Vol 128 (9) ◽  
pp. e236
Author(s):  
Nobuyuki Takeshige ◽  
Keiko Suematsu ◽  
Shinji Nakashima ◽  
Yui Nagata ◽  
Kiyohiko Sakata ◽  
...  
Keyword(s):  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Motor Pathway ◽  
Transcranial Motor Evoked Potential

scholarly journals The Interplay Between Neuroinfections, the Immune System and Neurological Disorders: A Focus on Africa

2022 ◽  
Vol 12 ◽  
Author(s):  
Leonard Ngarka ◽  
Joseph Nelson Siewe Fodjo ◽  
Esraa Aly ◽  
Willias Masocha ◽  
Alfred K. Njamnshi
Keyword(s):  
Immune System ◽  
Peripheral Neuropathy ◽  
Motor Neuron ◽  
Sleep Disorders ◽  
Neurological Disorders ◽  
Sub Saharan Africa ◽  
Primary Headaches ◽  
Headache Disorders ◽  
Motor Neuron Diseases ◽  
High Prevalence

Neurological disorders related to neuroinfections are highly prevalent in Sub-Saharan Africa (SSA), constituting a major cause of disability and economic burden for patients and society. These include epilepsy, dementia, motor neuron diseases, headache disorders, sleep disorders, and peripheral neuropathy. The highest prevalence of human immunodeficiency virus (HIV) is in SSA. Consequently, there is a high prevalence of neurological disorders associated with HIV infection such as HIV-associated neurocognitive disorders, motor disorders, chronic headaches, and peripheral neuropathy in the region. The pathogenesis of these neurological disorders involves the direct role of the virus, some antiretroviral treatments, and the dysregulated immune system. Furthermore, the high prevalence of epilepsy in SSA (mainly due to perinatal causes) is exacerbated by infections such as toxoplasmosis, neurocysticercosis, onchocerciasis, malaria, bacterial meningitis, tuberculosis, and the immune reactions they elicit. Sleep disorders are another common problem in the region and have been associated with infectious diseases such as human African trypanosomiasis and HIV and involve the activation of the immune system. While most headache disorders are due to benign primary headaches, some secondary headaches are caused by infections (meningitis, encephalitis, brain abscess). HIV and neurosyphilis, both common in SSA, can trigger long-standing immune activation in the central nervous system (CNS) potentially resulting in dementia. Despite the progress achieved in preventing diseases from the poliovirus and retroviruses, these microbes may cause motor neuron diseases in SSA. The immune mechanisms involved in these neurological disorders include increased cytokine levels, immune cells infiltration into the CNS, and autoantibodies. This review focuses on the major neurological disorders relevant to Africa and neuroinfections highly prevalent in SSA, describes the interplay between neuroinfections, immune system, neuroinflammation, and neurological disorders, and how understanding this can be exploited for the development of novel diagnostics and therapeutics for improved patient care.

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