J Korean Acad Rehabil Med.  2010 Feb;34(1):103-105.

Ipsilateral Motor Evoked Potentials in a Cerebral Palsy Child with Hemispheric Hypertrophy: A case report

• Ihm KJ
• Park SH
• Hwang SB
• Jo DS

Abstract

Congenital hemiplegia is a subtype of the cerebral palsies characterized by a predominantly spastic movement affecting on side of the body only. It is caused by brain lesions acquired during the prenatal, perinatal, or neonatal periods. It is generally assumed that the damage to the corticospinal tract accounts for most motor deficits in cerebral palsy patients. Ipsilateral motor evoked potentials are likely to be indicative of a profound functional reorganization of corticospinal projections originating from the undamaged hemisphere. The existence of the ipsilateral motor pathway from the unaffected hemisphere has been reported in hemiplegic cerebral palsy using the transcranial magnetic stimulation technique. Here, we report the case of a hemiparetic patient with severe unilateral brain atrophy including brain stem. Transcranial magnetic stimulation to the hypertrophic hemisphere elicited bilateral motor evoked potentials of the first dorsal interossei and ipsilateral responses were shorter onset latencies, implying direct ipsilateral corticospinal projections from the unaffected hemisphere.

Keyword

Corticospinal tract; Cerebral palsy

MeSH Terms

Atrophy
Brain
Brain Stem
Cerebral Palsy
Child
Evoked Potentials, Motor
Hemiplegia
Humans
Muscle Spasticity
Paralysis
Pyramidal Tracts
Transcranial Magnetic Stimulation