Motor evoked potentials in the preoperative and postoperative assessment of normal pressure hydrocephalus

Motor evoked potentials and central motor conduction time (CMCT) were examined from both upper and lower limbs in patients with normal pressure hydrocephalus to find a predictor for the success of shunting procedures. The hypotheses that walking disturbances are due to pyramidal tract compression as well as the possibility that the upper limbs are affected subclinically in these patients were also studied. The study suggests that the walking disturbances are not the result of a major pyramidal tract dysfunction but probably involve the sensorimotor integration leading to normal gait. Furthermore, CMCT measured with electromagnetic motor stimulation can help in selecting the patients that will benefit from shunting. The study does not provide electrophysiological evidence of upper limb involvement in normal pressure hydrocephalus.