title: Cortical silent period in two patients with meningioma and preoperative seizures: a pre- and postsurgical follow-up study.
abstract: OBJECTIVE
  Prolongation of the cortical silent period (CSP) following transcranial magnetic stimulation has been reported in patients with partial epilepsy involving the primary motor cortex (M1). This study aimed to investigate the relationship between the expected intraindividual variations in risk factors for seizures and CSP duration.
  
  
  METHODS
  We studied a 59-year-old woman with a rolandic meningioma and simple motor partial seizures and a 71-year-old woman with a parietal/occipital meningioma and complex partial seizures. Both patients had seizure as their initial symptom with complete postsurgical remission. Repeated pre- and postoperative CSP recordings were made from both first dorsal interosseous muscles. We compared the results to those obtained in 13 normals.
  
  
  RESULTS
  In the patient with simple motor partial seizures, the CSP was significantly prolonged in preoperative recordings and 3 weeks after surgery. This CSP lengthening partly subsided 3 months after surgery. Finally, the CSP was normal 6, 8, and 18 months after surgery. In the patient with complex partial seizures, no CSP change was observed.
  
  
  CONCLUSIONS
  In our patient with a rolandic meningioma, CSP prolongation was observed when the risk of seizure relapse was supposed to be higher (preoperative and early postoperative periods). This supports the view that CSP changes reflect compensatory mechanisms in M1 epilepsy.
authors.affiliation: Unità Operativa di Neurologia, Azienda Sanitaria di Firenze, Ospedale S. Maria Nuova, Piazza S. Maria Nuova 1, 50122, Florence, Italy. cincotta@unifi.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Cincotta
authors.forename: A
authors.initials: A
authors.lastname: Borgheresi
authors.forename: F
authors.initials: F
authors.lastname: Benvenuti
authors.forename: P
authors.initials: P
authors.lastname: Liotta
authors.forename: E
authors.initials: E
authors.lastname: Marin
authors.forename: G
authors.initials: G
authors.lastname: Zaccara
mesh_terms: D000328:Adult; D000368:Aged; D003344:Cortical Synchronization / Q000379:methods / Q000706:statistics & numerical data; D004828:Epilepsies, Partial / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000503:physiopathology* / Q000601:surgery; D008579:Meningioma / Q000503:physiopathology* / Q000601:surgery; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care / Q000706:statistics & numerical data; D012640:Seizures / Q000503:physiopathology* / Q000601:surgery