The role of motor evoked potentials in psychogenic paralysis.
METHODS
This prospective clinical study identified patients in whom paralysis developed after lumbar surgery.


OBJECTIVE
To determine whether patients with psychogenic paralysis could be identified using noninvasive techniques.


BACKGROUND
Before the advent of transcranial magnetic stimulation, no clinically applicable, noninvasive technique was available to confirm the integrity of the corticospinal tract.


METHODS
Patients with suspected postoperative psychogenic paralysis were evaluated by clinical examination and neurophysiologic work-up, including transcranial magnetic stimulation.


RESULTS
Six patients with psychogenic paralysis were identified in a 15-month period. In each case, motor evoked potentials could be demonstrated from the affected muscle(s), thus obviating the need for further invasive imaging or surgical exploration.


CONCLUSIONS
Transcranial magnetic stimulation is a reliable, painless, and noninvasive technique for demonstrating structural integrity of the corticospinal tracts.
Janssen
B A
BA
Department of Neurology, Schulthess Hospital, Zurich, Switzerland.
Theiler
R
R
Grob
D
D
Dvorak
J
J
D000328:Adult; D000368:Aged; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D009043:Motor Activity; D010243:Paralysis / Q000209:etiology / Q000523:psychology*; D011183:Postoperative Complications / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis*; D013131:Spine / Q000601:surgery*