engleski

Neurophysiological impairment in multiple sclerosis patient confirmed by transcranial magnetic stimulation of the central nervous system but not with electrical stimulation of peripheral nervous system.

Multiple sclerosis (MS) is currently an incurable autoimmune demyelinating and inflammatory disease affecting more than two million people worldwide. The neurophysiologic studies of the central nervous system (CNS) function comprising motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) reported consistent and substantial impairments in CNS generally correlating with disability. Studies of CNS showed prolonged central motor conduction times, asymmetry of nerve conduction motor pathways, and prolonged latencies, while resting motor threshold, MEP amplitude, and cortical silent periods showed conflicting results. Studies of peripheral nervous system (PNS) function comprising electroneuronography (ENG) reported impairments of the PNS in MS that were less pronounced and inconsistent. However, neurophysiological investigations applying both TMS and ENG are not frequently used in routine diagnostic procedures to elucidate neurophysiological changes in CNS and PNS in patients with MS. We describe a case of a patient with MS examined with TMS and ENG. The ENG findings did not show clinically meaningful deviations in the PNS of upper and lower extremity muscles. Simultaneously, TMS proved pathological findings in MEPs of upper and lower extremity muscles.

electroneuronography ; motor evoked potential ; multiple sclerosis ; TMS ; transcranial magnetic stimulation

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