Magnetic stimulation: examination of motor function in patients with cervical spine or cord lesion

In 20 patients with cervical spine or cord lesions, we examined motor evoked potentials (MEPs) by transcranially applied magnetic stimulation to the motor cortex. We used a large-diameter (12 cm) coil to induce equal current in both left and right hemispheres. The MEPs were recorded simultaneously from multiple muscles covering the C5 to C8 myotome distribution bilaterally. The MEP abnormalities correlated well with clinical muscle weakness in 15 patients. In two patients, MEP revealed abnormalities in muscles of normal strength. Three patients with sensory but without motor deficit had normal MEPs. We conclude that magnetic stimulation is a useful adjunct in confirming and objectifying motor weakness, and in localizing the level of dysfunction in cervical spine lesions.