[Is transcranial magnetic stimulation a helpful method in diagnosis of cervical myelopathy in patients with chronic polyarthritis?].
Fifty-seven patients with rheumatoid arthritis were examined clinically, radiologically, and by means of transcranial magnetic brain stimulation. With this method central motor conduction times of the corticospinal pathways can be measured. The aim of the study was to compare the different methods to detect a cervical myelopathy and to correlate them. In 90% of patients clinical signs of cervical myelopathy could be detected, although in two-thirds of these, the neurological deficit was minimal. Radiologically, over 50% of patients had an atlanto-axid dislocation (AAD) of more than 5 mm. The central motor latencies measured in the upper extremities were prolonged in 47% of cases. These results show the usefulness of transcranial magnetic brain stimulation as an additional noninvasive investigation for detecting compression of the cervical myelon. This is an additional useful criterion for determining the need for operative intervention.
Theiler
R
R
Klinik Wilhelm Schulthess, Abteilung für Neurologie und Rheumatologie, Zürich.
Dvorak
J
J
Janssen
B
B
Baumgartner
H
H
Herdmann
J
J
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology; D001268:Atlanto-Axial Joint / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D004568:Electrodiagnosis / Q000295:instrumentation*; D004574:Electromagnetic Fields; D004576:Electromyography / Q000295:instrumentation; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000294:innervation; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000503:physiopathology; D011930:Reaction Time / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology; D013126:Spinal Nerve Roots / Q000503:physiopathology; D013167:Spondylitis, Ankylosing / Q000175:diagnosis* / Q000503:physiopathology; D009435:Synaptic Transmission / Q000502:physiology
Ist die transkranielle Magnetstimulation eine hilfreiche Methode in der Diagnostik der zervikalen Myelopathie bei Patienten mit chronischer Polyarthritis?