Prognostic value of transcranial magnetic stimulation in acute stroke.

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Abstract
The aim of this study is to evaluate the role of motor-evoked potentials (MEPs) in predicting functional recovery of hemiparesis and hemiplegia in acute stroke patients. Twenty-seven acute stroke patients were evaluated clinically and electrophysiologically within the first week and 3 to 6 months after the event. Clinical assessment included a quantitative evaluation of motor ability and activities of daily living. MEPs were recorded from the abductor pollicis brevis and tibialis anterior muscles bilaterally. Correlations between clinical parameters and MEPs were assessed. In the acute period, no MEP could be detected in 17 of 27 patients. In these 17 patients, the clinical scores were worse than in the patients whose MEPs could be elicited. However, in the follow-up period (3 to 6 months), no significant differences in motor function were observed between the two groups. In the acute phase of stroke, neurophysiological parameters were correlated with the clinical findings, but MEPs had no value in predicting the outcome of hemiparesis and hemiplegia.