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The role of motor evoked potentials in psychogenic paralysis
B A Janssen1, R Theiler, D Grob
1Department of Neurology, Schulthess Hospital, Zurich, Switzerland.
Study Design:
This prospective clinical study identified patients in whom paralysis developed after lumbar surgery.
Objective:
To determine whether patients with psychogenic paralysis could be identified using noninvasive techniques.
Summary Of Background Data:
Before the advent of transcranial magnetic stimulation, no clinically applicable, noninvasive technique was available to confirm the integrity of the corticospinal tract.
Methods:
Patients with suspected postoperative psychogenic paralysis were evaluated by clinical examination and neurophysiologic work-up, including transcranial magnetic stimulation.
Results:
Six patients with psychogenic paralysis were identified in a 15-month period. In each case, motor evoked potentials could be demonstrated from the affected muscle(s), thus obviating the need for further invasive imaging or surgical exploration.
Conclusions:
Transcranial magnetic stimulation is a reliable, painless, and noninvasive technique for demonstrating structural integrity of the corticospinal tracts.