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Navigated transcranial magnetic stimulation to measure motor evoked potentials in a child with hemispheric polymicrogyria and focal epilepsy

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Abstract

Malformations of cortical development such as polymicrogyria can cause medically refractory epilepsy. Epilepsy surgery (hemispherotomy) can be a good treatment option. In recent years, navigated transcranial magnetic stimulation (nTMS), a noninvasive brain mapping technique, has been used to localize the eloquent cortex for presurgical evaluation of patients with epilepsy. In the present case study, neurophysiological markers of the primary motor cortex (M1), including resting motor threshold (rMT), motor evoked potentials (MEPs), and silent period (SP), were assessed in both hands of a right-handed 10-year-old girl with a history of epilepsy and right hemispheric polymicrogyria. Bilateral MEPs with short latencies were elicited from the contralesional side. The average MEP amplitude and the latency for the patient’s paretic and non-paretic hands differed significantly. We conclude that nTMS is a safe and tolerable procedure that can be used for presurgical evaluation in children with intractable epilepsy.

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Abbreviations

nTMS:

Navigated transcranial magnetic stimulation

M1:

Primary motor cortex

rMT:

Resting motor threshold

MEP:

Motor evoked potential

SP:

Silent period

DCS:

Direct cortical stimulation

EMG:

Electromyography

APB:

Abductor pollicis brevis

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Acknowledgements

We thank the patient and his family for cooperating with this study.

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Authors and Affiliations

  1. Pediatric neurology Department, Neuroscience Center, King Fahad Specialist Hospital Dammam, P.O. Box 15215, Dammam, 31444, Saudi Arabia

    Ali Mir, Raidah AlBaradie & Shahid Bashir

Authors
  1. Ali Mir
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  2. Raidah AlBaradie
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  3. Shahid Bashir
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Contributions

AM, RA and SB contributed to initial drafts of this publication; AM and SB revised later drafts. All authors reviewed and approved the final draft.

Corresponding author

Correspondence to Shahid Bashir.

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King Fahad Specialist Hospital Dammam committee on human research approved this study, and informed consent was obtained from the subject.

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The authors declare no competing interests.

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Mir, A., AlBaradie, R. & Bashir, S. Navigated transcranial magnetic stimulation to measure motor evoked potentials in a child with hemispheric polymicrogyria and focal epilepsy. Childs Nerv Syst 40, 957–960 (2024). https://doi.org/10.1007/s00381-023-06196-5

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  • DOI: https://doi.org/10.1007/s00381-023-06196-5

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