Prediction of motor function by magnetic brain stimulation in patients with intracerebral hematoma

Corticospinal motor pathways were monitored with motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation in 13 patients with radiologically confirmed hypertensive intracerebral hemorrhage and varying degrees of hemiparesis. The electromyographic responses of the thenar muscles were recorded. The motor weakness of the upper extremity was assessed at initial monitoring and 3 months after hemorrhage, and correlated with changes in MEP. Absence of MEP in the acute stage indicated poor recovery of muscle strength. No false negative results were seen in our series. The presence of MEP in a completely hemiplegic patient predicted some recovery of motor function. The suppression of amplitude was more accurate than prolongation of latency in predicting the functional recovery. MEP monitoring of patients with hypertensive intracerebral hemorrhage in the acute stage can predict the outcome of motor function.