Clinical results of cervical myelopathy in patients older than 80 years of age: evaluation of spinal function with motor evoked potentials

2009 ◽  
Vol 11 (4) ◽  
pp. 421-426 ◽  
Author(s):  
Nobuhiro Tanaka ◽  
Kazuyoshi Nakanishi ◽  
Yoshinori Fujimoto ◽  
Hirofumi Sasaki ◽  
Naosuke Kamei ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Motor Evoked Potentials ◽  
Japanese Orthopaedic Association ◽  
Motor Evoked Potential ◽  
Posterior Longitudinal Ligament ◽  
Clinical Results ◽  
Conduction Time ◽  
Average Recovery Rate ◽  
The Mean ◽  
Spinal Function

Object In this prospective analysis the authors describe the clinical results of surgical treatment in patients > 80 years of age in whom spinal function was evaluated with motor evoked potential (MEPs) monitoring. Methods The authors included 57 patients > 80 years of age who were suspected of having cervical myelopathy. The mean age of the patients was 83.0 years (range 80–90 years). The central motor conduction time (CMCT) was calculated from the latencies of the MEPs following transcranial magnetic stimulation and from M and F waves following peripheral nerve stimulation. Results Preoperative electrophysiological evaluation demonstrated significant elongation of CMCT or abnormalities in MEP waveforms in 37 patients (65%), and 35 patients of these underwent laminoplasty. In 30 patients cervical spondylotic myelopathy was diagnosed and 5 patients ossification of the posterior longitudinal ligament was diagnosed. The preoperative mean Japanese Orthopaedic Association Scale score was 8.6 (range 3–12.5) and the mean postoperative score was 12.6 (range 6–14.5) with an average recovery rate of 45% (range −21 to 100%). There were no major complications in any of the patients during the operative period and there were no cases of death resulting from operative intervention. Conclusions Sufficient clinical results are expected even in patients with myelopathy who are older than 80 years of age, provided the patients are correctly selected by electrophysiological evaluation with MEPs and CMCT.

scholarly journals Anterior selective stabilization combined with laminoplasty for cervical myelopathy due to massive ossification of the posterior longitudinal ligament: report of early outcomes in 14 patients

2020 ◽  
Vol 33 (1) ◽  
pp. 58-64 ◽  
Author(s):  
Yukitaka Nagamoto ◽  
Motoki Iwasaki ◽  
Shinya Okuda ◽  
Tomiya Matsumoto ◽  
Tsuyoshi Sugiura ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Recovery Rate ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Radiographic Parameters ◽  
Selective Stabilization ◽  
The Mean ◽  
Segmental Lordosis ◽  
Compression Level

OBJECTIVESurgical management of massive ossification of the posterior longitudinal ligament (OPLL) is challenging. To reduce surgical complications, the authors have performed anterior selective stabilization combined with laminoplasty (antSS+LP) for massive OPLL since 2012. This study aimed to elucidate the short-term outcome of the antSS+LP procedure.METHODSThe authors’ analysis was based on data from 14 patients who underwent antSS+LP for cervical myelopathy caused by massive OPLL and were followed up for at least 2 years after surgery (mean follow-up duration 3.3 years). Clinical outcome was evaluated preoperatively, at 6 months and 1 year postoperatively, and at the final follow-up using the Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy and the recovery rate of the JOA score. The following radiographic parameters were measured preoperatively, immediately after surgery, at 1 year after surgery, and at the final follow-up: the C2–7 angle, measured on lateral plain radiographs, and the segmental lordosis angle (SLA), measured on sagittal CT scans. The correlation between radiographic parameters and clinical outcomes was evaluated.RESULTSThe mean JOA score increased from 10.4 before surgery to 13.6 and 13.8 at 6 months and 1 year after surgery, respectively; at the final follow-up the mean score was 13.4. This postoperative recovery was significant (p = 0.004) and was maintained until the final follow-up. No patient required revision surgery due to postoperative neurological deterioration. However, the C2–7 angle gradually deteriorated postoperatively. Similarly, the SLA was significantly increased immediately after surgery, but the improvement was not maintained. The recovery rate at the final follow-up correlated positively with the change in C2–7 angle (r = 0.60, p = 0.03) and the change in SLA (r = 0.72, p < 0.01).CONCLUSIONSAntSS+LP is safe and effective and may be an alternative to anterior decompression and fusion for the treatment of patients with massive OPLL. No postoperative neurological complications or significant postoperative exacerbation of neck pain were observed in our case series. Not only reducing intervertebral motion and decompressing the canal at the maximal compression level but also acquiring segmental lordosis at the maximal compression level are crucial factors for achieving successful outcomes of antSS+LP.

Is there a difference in range of motion, neck pain, and outcomes in patients with ossification of posterior longitudinal ligament versus those with cervical spondylosis, treated with plated laminoplasty?

2013 ◽  
Vol 35 (1) ◽  
pp. E9 ◽  
Author(s):  
Takahito Fujimori ◽  
Hai Le ◽  
John E. Ziewacz ◽  
Dean Chou ◽  
Praveen V. Mummaneni
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Clinical Outcomes ◽  
San Francisco ◽  
Japanese Orthopaedic Association ◽  
Minimum Clinically Important Difference ◽  
Posterior Longitudinal Ligament ◽  
Flexion Angle ◽  
Radiographic Outcomes ◽  
The Mean

Object There are little data on the effects of plated, or plate-only, open-door laminoplasty on cervical range of motion (ROM), neck pain, and clinical outcomes. The purpose of this study was to compare ROM after a plated laminoplasty in patients with ossification of posterior longitudinal ligament (OPLL) versus those with cervical spondylotic myelopathy (CSM) and to correlate ROM with postoperative neck pain and neurological outcomes. Methods The authors retrospectively compared patients with a diagnosis of cervical stenosis due to either OPLL or CSM who had been treated with plated laminoplasty in the period from 2007 to 2012 at the University of California, San Francisco. Clinical outcomes were measured using the modified Japanese Orthopaedic Association (mJOA) scale and neck visual analog scale (VAS). Radiographic outcomes included assessment of changes in the C2–7 Cobb angle at flexion and extension, ROM at C2–7, and ROM of proximal and distal segments adjacent to the plated lamina. Results Sixty patients (40 men and 20 women) with an average age of 63.1 ± 10.9 years were included in the study. Forty-one patients had degenerative CSM and 19 patients had OPLL. The mean follow-up period was 20.9 ± 13.1 months. The mean mJOA score significantly improved in both the CSM and the OPLL groups (12.8 to 14.5, p < 0.01; and 13.2 to 14.2, respectively; p = 0.04). In the CSM group, the mean VAS neck score significantly improved from 4.2 to 2.6 after surgery (p = 0.01), but this improvement did not reach the minimum clinically important difference (MCID). Neither was there significant improvement in the VAS neck score in the OPLL group (3.6 to 3.1, p = 0.17). In the CSM group, ROM at C2–7 significantly decreased from 32.7° before surgery to 24.4° after surgery (p < 0.01). In the OPLL group, ROM at C2–7 significantly decreased from 34.4° to 20.8° (p < 0.01). In the CSM group, the change in the VAS neck score significantly correlated with the change in the flexion angle (r = − 0.31) and the extension angle (r = − 0.37); however, it did not correlate with the change in ROM at C2–7 (r = − 0.1). In the OPLL group, the change in the VAS neck score did not correlate with the change in the flexion angle (r = 0.03), the extension angle (r = − 0.17), or the ROM at C2–7 (r = − 0.28). The OPLL group had a significantly greater loss of ROM after surgery than did the CSM group (p = 0.04). There was no significant correlation between the change in ROM and the mJOA score in either group. Conclusions Plated laminoplasty in patients with either OPLL or CSM decreases cervical ROM, especially in the extension angle. Among patients who have undergone laminoplasty, those with OPLL lose more ROM than do those with CSM. No correlation was observed between neck pain and ROM in either group. Neither group had a change in neck pain that reached the MCID following laminoplasty. Both groups improved in neurological function and outcomes.

scholarly journals Comparison of Laminoplasty and Posterior Fusion Surgery for Cervical Ossification of Posterior Longitudinal Ligament

2021 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Shiro Imagama ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Kenichiro Sakai ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Perioperative Complications ◽  
Clinical Status ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Posterior Fusion ◽  
Postoperative Outcomes ◽  
Intensity Change ◽  
Multivariable Logistic Regression Analysis ◽  
Significant Difference

Abstract This prospective multicenter study formed by the Japanese Ministry of Health, Labour and Welfare at 27 institutions aimed to compare postoperative outcomes between laminoplasty (LM) and posterior fusion (PF) for cervical ossification of the posterior longitudinal ligament (OPLL). Controversy exists regarding the role of instrumented fusion in the context of posterior surgical decompression for OPLL. Among the 479 patients enrolled, 189 (137 and 52 patients with LM and PF, respectively) were included and evaluated using the Japanese Orthopaedic Association (JOA) scores, the JOA Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and radiographical measurements. Basic demographic and radiographical data were reviewed, and the propensity to choose a surgical procedure was calculated. Preoperatively, patient backgrounds, radiographical measurements (K-line or cervical alignment on X-ray, OPLL occupation ratio on computed tomography, and increased signal intensity change on magnetic resonance imaging), or clinical status (JOA score and JOACMEQ) after adjustments showed no significant differences. The overall risk of perioperative complications was lower in LM (odds ratio [OR] 0.40, p = 0.006), and C5 palsy was significantly lower in LM (OR 0.11, p = 0.0002) than in PF. The range of motion (20.91° ± 1.05° and 9.38° ± 1.24°, p < 0.0001) in patients with PF was significantly smaller than in those with LM. However, multivariable logistic regression analysis showed no significant difference in JOA score, JOA recovery rate, or JOACMEQ improvement at two years. In contrast, OPLL progression was greater in LM group than in the PF group (OR 2.73, p = 0.0002). LM and PF for cervical myelopathy due to OPLL resulted in comparable postoperative outcomes at two years after surgery.

scholarly journals Adjunct Diagnostic Value of Transcranial Magnetic Stimulation in Mucopolysaccharidosis-Related Cervical Myelopathy: A Pilot Study

2019 ◽  
Vol 9 (8) ◽  
pp. 200 ◽  
Author(s):  
Mariagiovanna Cantone ◽  
Giuseppe Lanza ◽  
Alice Le Pira ◽  
Rita Barone ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Cervical Myelopathy ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Hot Spot ◽  
Diagnostic Value ◽  
Lower Limbs ◽  
Conduction Time ◽  
Variable Degree ◽  
Monitoring Methods

Background: Cervical myelopathy (CM) is a common cause of morbidity and disability in patients with mucopolysaccharidosis (MPS) and, therefore, early detection is crucial for the best surgical intervention and follow-up. Transcranial magnetic stimulation (TMS) non-invasively evaluates the conduction through the cortico-spinal tract, also allowing preclinical diagnosis and monitoring. Methods: Motor evoked potentials (MEPs) to TMS were recorded in a group of eight patients with MPS-related CM. Responses were obtained during mild tonic muscular activation by means of a circular coil held on the “hot spot” of the first dorsal interosseous and tibialis anterior muscles, bilaterally. The motor latency by cervical or lumbar magnetic stimulation was subtracted from the MEP cortical latency to obtain the central motor conduction time. The MEP amplitude from peak to peak to cortical stimulation and the interside difference of each measure were also calculated. Results: TMS revealed abnormal findings from both upper and lower limbs compatible with axonal damage and demyelination in six of them. Notably, a subclinical cervical spinal disease was detected before the occurrence of an overt CM in two patients, whereas TMS signs compatible with a CM of variable degree persisted despite surgery in all treated subjects. Conclusions: TMS can be viewed as an adjunct diagnostic test pending further rigorous investigations.

Conservative management of ossification of the posterior longitudinal ligament

2011 ◽  
Vol 30 (3) ◽  
pp. E2 ◽  
Author(s):  
Martin H. Pham ◽  
Frank J. Attenello ◽  
Joshua Lucas ◽  
Shuhan He ◽  
Christopher J. Stapleton ◽  
...  
Keyword(s):  
Conservative Management ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Japanese Orthopaedic Association Score ◽  
Clinical Progression ◽  
Association Score ◽  
Rate Of Progression ◽  
The Mean ◽  
High Chance

Object Ossification of the posterior longitudinal ligament (OPLL) can result in significant myelopathy. Surgical treatment for OPLL has been extensively documented in the literature, but less data exist on conservative management of this condition. Methods The authors conducted a systematic review to identify all reported cases of OPLL that were conservatively managed without surgery. Results The review yielded 11 published studies reporting on a total of 480 patients (range per study 1–359 patients) over a mean follow-up period of 14.6 years (range 0.4–26 years). Of these 480 patients, 348 (72.5%) were without myelopathy on initial presentation, whereas 76 patients (15.8%) had signs of myelopathy; in 56 cases (15.8%), the presence of myelopathy was not specified. The mean aggregate Japanese Orthopaedic Association score on presentation for 111 patients was 15.3. Data available for 330 patients who initially presented without myelopathy showed progression to myelopathy in 55 (16.7%), whereas the other 275 (83.3%) remained progression free. In the 76 patients presenting with myelopathy, 37 (48.7%) showed clinical progression, whereas 39 (51.5%) remained clinically unchanged or improved. Conclusions Patients who present without myelopathy have a high chance of remaining progression free. Those who already have signs of myelopathy at presentation may benefit from surgery due to a higher rate of progression over continued follow-up.

Radiculopathy of C-5 after anterior decompression for cervical myelopathy

2005 ◽  
Vol 3 (3) ◽  
pp. 210-217 ◽  
Author(s):  
Minoru Ikenaga ◽  
Jitsuhiko Shikata ◽  
Chiaki Tanaka
Keyword(s):  
Cervical Myelopathy ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Manual Muscle Testing ◽  
Radiographic Evaluation ◽  
Anterior Decompression ◽  
Content Type ◽  
Muscle Testing ◽  
Anterior Corpectomy ◽  
Fine Print

Object. The authors conducted a study to examine the incidence and causes of postoperative C-5 radiculopathy, and they suggest preventive methods for C-5 palsy after anterior corpectomy and fusion. Methods. The authors included in the study 18 patients with postoperative C-5 radiculopathy from 563 patients who underwent anterior decompression and fusion for cervical myelopathy. There were 10 cases of ossification of the posterior longitudinal ligament (OPLL) and eight cases of cervical spondylotic myelopathy (CSM). All patients received conservative treatment. Posttreatment full recovery was present in eight patients, and Grade 3/5 strength was documented in six in whom some weakness remained. Radiographic evaluation revealed that the C3–4 and C4–5 cord compression was significantly more severe in patients with paralysis than in those without paralysis. The incidence of paralysis was higher in patients with OPLL than in those with CSM (chi-square test, p = 0.03). The incidence of paralysis increased in parallel with the number of fusion levels (correlation coefficient r = 0.94). Multivariate analysis revealed that the final manual muscle testing (MMT) value was closely related to the preoperative MMT value (computed t value 4.17; p < 0.01) and preoperative Japanese Orthopaedic Association (JOA) score for cervical myelopathty (computed t value, 2.75; p < 0.05). Conclusions. Preexisting severe stenosis at C3–4 or C4–5 in patients with OPLL is a risk factor for paralysis. Preoperative muscle weakness and a low JOA score are factors predictive of poor recovery.

Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy

1997 ◽  
Vol 86 (6) ◽  
pp. 990-997 ◽  
Author(s):  
R. Loch Macdonald ◽  
Michael G. Fehlings ◽  
Charles H. Tator ◽  
Andres Lozano ◽  
J. Ross Fleming ◽  
...  
Keyword(s):  
Cervical Myelopathy ◽  
Cerebrospinal Fluid Leak ◽  
Posterior Longitudinal Ligament ◽  
Morbidity Rate ◽  
Preoperative Pain ◽  
Duration Of Symptoms ◽  
Content Type ◽  
Cervical Corpectomy ◽  
The Mean ◽  
Anterior Cervical Corpectomy

✓ This study was conducted to determine the safety and efficacy of multilevel anterior cervical corpectomy and stabilization using fibular allograft in patients with cervical myelopathy. Thirty-six patients underwent this procedure for cervical myelopathy caused by spondylosis (20 patients), ossified posterior longitudinal ligament (four patients), trauma (one patient), or a combination of lesions (11 patients). The mean age (± standard deviation) of the patients was 58 ± 10 years and 30 of the patients were men. The mean duration of symptoms before surgery was 30 ± 6 months and 11 patients had undergone previous surgery. Prior to surgery, the mean Nurick grade of the myelopathy was 3.1 ± 1.4. Seventeen patients also had cervicobrachial pain. Four vertebrae were removed in six patients, three in 19, and two in 11 patients. Instrumentation was used in 15 cases. The operative mortality rate was 3% (one patient) and two patients died 2 months postoperatively. Postoperative complications included early graft displacement requiring reoperation (three patients), transient dysphagia (two patients), cerebrospinal fluid leak treated by lumbar drainage (three patients), myocardial infarction (two patients), and late graft fracture (one patient). One patient developed transient worsening of myelopathy and three developed new, temporary radiculopathies. All patients achieved stable bone union and the mean Nurick grade at an average of 31 6 20 months (range 0–79 months) postoperatively was 2.4 ± 1.6 (p < 0.05, t-test). Cervicobrachial pain improved in 10 (59%) of the 17 patients who had preoperative pain and myelopathy improved at least one grade in 17 patients (47%; p < 0.05). Twenty-six surviving patients (72%) were followed for more than 24 months and stable, osseous union occurred in 97%. These results show that extensive, multilevel anterior decompression and stabilization using fibular allograft can be achieved with a perioperative mortality and major morbidity rate of 22% and with significant improvement in pain and myelopathy.

Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion

2011 ◽  
Vol 14 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Jason M. Highsmith ◽  
Sanjay S. Dhall ◽  
Regis W. Haid ◽  
Gerald E. Rodts ◽  
Praveen V. Mummaneni
Keyword(s):  
Neck Pain ◽  
Japanese Orthopaedic Association ◽  
Length Of Hospital Stay ◽  
Posterior Longitudinal Ligament ◽  
Complication Rates ◽  
Cervicothoracic Junction ◽  
Pain Scores ◽  
Vas Scores ◽  
The Mean ◽  
Cervical Stenotic Myelopathy

Object Cervical stenotic myelopathy due to spondylosis or ossification of the posterior longitudinal ligament is often treated with laminoplasty or cervical laminectomy (with fusion). The goal of this study was to compare outcomes, radiographic results, complications, and implant costs associated with these 2 treatments. Methods The authors analyzed the records of 56 patients (age range 42–81 years) who were surgically treated for cervical stenosis. Of this group, 30 underwent laminoplasty and 26 underwent laminectomy with fusion. Patients who had cervical kyphosis or spondylolisthesis were excluded. An average of 4 levels were instrumented in the laminoplasty group and 5 levels in the fusion group (p < 0.01). Forty-two percent of the fusions crossed the cervicothoracic junction, but no laminoplasty instrumentation crossed the cervicothoracic junction, and it only reached C-7 in one-third of the cases. Preoperative and postoperative Nurick grades and modified Japanese Orthopaedic Association (mJOA) scores were obtained. Outcomes were also assessed with neck pain visual analog scale (VAS) scores and the Odom outcome criteria. Postoperative length of stay, complications, and implant costs were calculated. Results The mean duration of follow-up, average patient age, and length of hospital stay were similar for both groups. The mean Nurick scores were also similar in the 2 groups and improved an average of 1.4 points in both (p < 0.01 for preoperative-postoperative comparison in each group). The mean mJOA scores improved 2.7 points in laminoplasty patients and 2.8 points in fusion patients (p < 0.01 for each group). The mean VAS scores for neck pain did not change significantly in the laminoplasty cohort (3.2 ± 2.8 [SD] preoperatively vs 3.4 ± 2.6 postoperatively, p = 0.50). In the fusion cohort, the mean VAS scores improved from 5.8 ± 3.2 to 3.0 ± 2.3 (p < 0.01). Excellent or good Odom outcomes were observed in 76.7% of the patients in the laminoplasty cohort and 80.8% of those in the fusion cohort (p = 0.71). In the fusion group, complications were twice as common and implant costs were nearly 3 times as high as in the laminoplasty group. When cases involving fusions crossing the cervicothoracic junction were excluded, analysis showed similar complication rates in the 2 groups. Conclusions Patients treated with laminoplasty and patients treated with laminectomy and fusion had similar improvements in Nurick scores, mJOA scores, and Odom outcomes. Patients who underwent fusion typically had higher preoperative neck pain scores, but their neck pain improved significantly after surgery. There was no significant change in the neck pain scores of patients treated with laminoplasty. Our series suggests cervical fusion significantly reduces neck pain in patients with stenotic myelopathy, but that the cost of the implant and rate of reoperation are greater than in laminoplasty.

scholarly journals Double Dome Laminoplasty: A Novel Technique for C2 Decompression

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 882-888
Author(s):  
Dong-Ho Lee ◽  
Gian Karlo P. Dadufalza ◽  
Jong-Min Baik ◽  
Sehan Park ◽  
Jae Hwan Cho ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Neck Pain ◽  
Cervical Myelopathy ◽  
Analogue Scale ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Patient Reported ◽  
Laminar Fracture ◽  
Cervical Spine Alignment ◽  
New Surgical Technique

Objective: To introduce a new surgical technique - double dome laminoplasty for decompression of the entire C2 lamina and preservation of an extensor muscle insertion.Methods: Eleven consecutive cervical myelopathy patients due to ossification of the posterior longitudinal ligament involving the Axis (C2) area were contained at this study. Direct decompression was evaluated as an increasing rate in space available cord (%) and posterior cord shift (mm) at C2 level. The Japanese Orthopaedic Association (JOA) score, visual analogue scale, and C2–7 Cobb angle in a neutral lateral x-ray were analyzed.Results: The mean increase in space available for spinal cord at the C2 level, average posterior cord shift, and JOA recovery rate were 69.7%, 5.3 ± 0.15 mm, and 58.0%, respectively. Cervical lordotic angle was maintained in all patients. One patient reported neck pain (visual analogue scale 6) postoperatively. No specific complications such as C2 laminar fracture or insufficient decompression were observed.Conclusion: We recommend double dome laminoplasty for treating patients with cervical myelopathy involving the C2 area to avoid C2 laminectomy, reduce postoperative neck pain, and maintain lordotic cervical spine alignment.

scholarly journals Peculiarities of motor evoked potential in healthy children of different age

2019 ◽  
Vol 19 (4) ◽  
pp. 228-231
Author(s):  
Vladislav B. Voitenkov ◽  
N. V. Skripchenko ◽  
A. V. Klimkin ◽  
A. I. Aksenova
Keyword(s):  
Normative Data ◽  
Evoked Potential ◽  
Motor Evoked Potentials ◽  
Pediatric Population ◽  
Motor Evoked Potential ◽  
Conduction Time ◽  
Healthy Children ◽  
Abductor Hallucis ◽  
Abductor Pollicis Brevis ◽  
Pediatric Disorders

Aim of the work The implementation of the database for reference values of motor evoked potentials (MEP) in healthy children of different ages. Methods 95 healthy children were enrolled. Age ranged from 1 to 204 months. Three subgroups were established: children of 1-12 months (n=31, 18 males, 13 females), 12-144 months (n=27, 14 males, 13 females) and 144-204 (n=37, 20 males, 17 females) months. All children were healthy. Diagnostic transcranial magnetic stimulation (TMS) was performed in all patients. MEP shape, threshold, latency and amplitudes were recorded for hands (m. Abductor pollicis brevis) and legs (m. Abductor Hallucis). Central motor conduction time (CMCT) was calculated. Results. Along with age there was observed the elongation of MEP latency, gain in amplitudes and shape normalization. There were significant differences in the elongation of MEP latency between children aged of 1-12 months and children from two other subgroups (12-144 and 144-204 months). Conclusions. Our normative data can be usedfor comparative studies in the broad spectrum of pediatric disorders. Age restrictions have to be taken in a consideration when performing the TMS in pediatric population.

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