Hypoglossal Nerve Conduction Study by Transcranial Magnetic Stimulation in Normal Subjects

The introduction of transcranial magnetic stimulation has allowed the study of conduction in the proximal portions and central pathways of the cranial nerves. A study is made of cranial nerve XII with transcranial magnetic stimulation at two levels, cortical and cisternal, registering the motor evoked potential by means of surface electrodes in contact with the upper face of the tongue. Motor evoked potentials were constantly observed on cortical stimulation, in a painless, easy, and reproducible way, with mean values of 10.84 ± 1.14 milliseconds (latency) and 7.81 ± 1.14 mV (amplitude). Motor evoked potentials were unconstant and showed reduced amplitues on cisternal stimulation, with mean values of 4.72 ± 0.62 milliseconds and 0.83 ± 1.26 mV. The magnetic stimulation technique allows the study of the entire motor pathway of cranial nerve XII (motor cortex-medulla, motoneuron-muscle). The method is efficient, noninvasive, painless, and easily reproduced, and it comes close to being an ideal clinical conduction study technique for this cranial nerve.