Neurophysiological Invetigation Of Epileptic Seizures In Man By Combined Use Of Stretch And H Reflex And Transcranial Magnetic Stimulation
Carlo A. Tassinari, Franco Valzania, Roberto Michelucci, Guido Rubboli, Francesca Pastorelli, Anna Z

To Elucidate The Mechanisms Of Motor Involvement During Clinical And Subclinical Epileptic Discharges. Methods: Motor System
Assessment During Paroxysmal Discharges Was Performed By Means Of Single Pulse Transcranial Magnetic Stimulation (TMS) With
Recording Of Motor Evoked Potentials (MEPs), H Reflex, And Stretch Reflex Induced By Computerized Posturography. 1 Patient With
Epilepsia Partialis Continua, 2 Patients With Absence Seizures (n=20) And Subclinical Photic-induced Generalized Spike-wave
Discharges (n=45), 6 Patients With Tonic Seizures During Sleep (n=55) Were Investigated.

In The Patient With Epilepsia Partialis Continua, The Only MEP Abnormality Was A Significantly Lower Threshold Intensity Of Cortical
Stimulation In The Affected Hemisphere. In The 2 Cases With Subclinical Photic-induced Paroxysmal Discharges, MEPs Showed
Similar Amplitude And Latency To Those Recorded During Interictal Periods. MEPs Elicited During Sleep-linked Fast Recruiting Rhythms
(with Or Without Concomitant EMG Tonic Activation), In Patients With Tonic Seizures, Were Either Increased Or Decreased In
Amplitude As Compared To Interictal Periods. In This Latter Group, H Reflex Was Constantly Increased During The Discharges, The
Maximal Amplitude Being Obtained In Concomitance With Seizure-related Tonic EMG Activity. Evaluation Of Stretch Reflex Provided
Similar Findings.

Our Data Suggest That Even Infraclinical Epileptic Discharges May Induce Variations Of Motor Excitability, Both At A Cortical Or Spinal




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