Abstract
To evaluate motor cortex excitability as a function of lateralization relative to the seizure focus in child with intractable epilepsy undergoing navigated transcranial magnetic stimulation (nTMS) for presurgical mapping. nTMS is a method for focal noninvasive cortical stimulation where small intracranial electrical currents are generated by a powerful extracranial fluctuating magnetic field. Resting motor threshold (rMT), motor evoked potentials (MEPs), silent period (SP) serves as a measure of motor cortex excitability was assessed in both hands in 10 year old right-handed girl k/c of epilepsy and left side hemiparesis. There was significant difference in rMT, MEPs and SP between the hemispheres. The response of MEPs was more towards unaffected hemisphere. nTMS is a safe and tolerable procedure in children with intractable epilepsy. These results highlighted the potential for inducing lasting modulation of excitability in M1 by navigated TMS of the healthy M1, possibly reflecting modulation of interactions and demonstrating the potential use of such a paradigm.
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