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Usefulness of transcranial magnetic stimulation to predict the development of reflex sympathetic dystrophy poststroke: a pilot study.

par Dachy, Bernard ;Denis, Louis;Deltenre, Paul
Référence Archives of physical medicine and rehabilitation, 83, 5, page (730-732)
Publication Publié, 2002-05

Article révisé par les pairs

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Résumé :

OBJECTIVE: To investigate the predictive value of transcranial magnetic stimulation (TMS) for the development of reflex sympathetic dystrophy (RSD) poststroke. DESIGN: Blind clinical assessment of 2 groups of stroke patients defined on the basis of absent or preserved motor evoked potentials (MEPs) on the affected side. SETTING: Stroke rehabilitation center. PATIENTS: Twenty stroke patients between the ages of 41 and 85 years, undergoing rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: MEPs from upper limbs 30 days poststroke, Motricity Index, and scoring of RSD using the Enjalbert Scale 73 days poststroke. RESULTS: A good correlation was found between Motricity Index and TMS results (P<.01). Average Enjalbert scores were significantly different between the 2 groups (P=.03). No significant correlation was found between Enjalbert scores and the Motricity Index. CONCLUSIONS: Although no significant relationship was found between upper-limb motor impairment and intensity of RSD 10 weeks after stroke, the TMS responses permitted the early categorization of patients into 2 groups that developed significantly different average Enjalbert scores 1 to 2 months later when this clinical condition was fully developed.