Ipsilateral Motor Evoked Potentials in a Preschool-age Child With Traumatic Brain Injury: A Case Report
Seong-Yeol Kim1, Choong-Hee Roh1, Da-Sol Kim1
1Department of Physical Medicine and Rehabilitation, Jeonbuk National University Hospital, Jeonju, Korea.
Insights
The upper age limit for cerebral palsy (CP) manifestation is unclear. This case report shows ipsilateral motor evoked potentials (iMEPs) in a 4-year-old, suggesting iMEPs may indicate brain plasticity beyond previous observations.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Clinical Neurology
Background:
- The upper age limit for post-neonatal cerebral palsy (CP) manifestation is uncertain due to a lack of objective brain assessment tools.
- Previous research indicated that ipsilateral corticospinal projections, observed in CP patients' paretic hands, were not seen in individuals over 2 years old.
Observation:
- This case report details a 4-year-old girl with traumatic brain injury.
- The patient exhibited ipsilateral motor evoked potentials (iMEPs), a finding previously unobserved in individuals over 2 years old.
Findings:
- This represents the oldest documented case of brain injury with maintained iMEPs.
- The presence of iMEPs in this older child challenges previous age limitations.
Implications:
- Ipsilateral motor evoked potentials (iMEPs) may serve as a crucial indicator of motor system plasticity in the developing brain.
- This finding could refine our understanding of brain injury recovery and developmental trajectories in children.
- Further research is warranted to explore the diagnostic and prognostic value of iMEPs in pediatric neurology.
Abstract:
To the best of our knowledge, the upper age limit at which post-neonatal cerebral palsy (CP) can manifest remains uncertain. This uncertainty is attributed to the lack of objective parameters for assessing the developing brain. In a previous study, we reported that an ipsilateral corticospinal projection associated with brain injury, as manifested in the paretic hand of a CP patient, had never been observed in individuals aged > 2 years. In this case report, we present an instance of ipsilateral motor evoked potential (iMEP) in a girl whose traumatic brain injury occurred at the age of 4 years. This case is the oldest in which brain injury occurred and iMEP was maintained. In conclusion, iMEP can be a valuable indicator of motor system plasticity in the developing brain.
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