RESUMEN
A stroke patient with right hemiplegia and mirror movement underwent transcranial magnetic stimulation (TMS) and somatosensory-evoked potential (SEP) testing. The motor-evoked potentials (MEPs) of both abductor pollicis brevis muscles after stimulating the unaffected right hemisphere showed similar latencies, and were potentially produced by corticospinal tracts from the same motor cortex. N(20) responses of SEPs were recorded at C(4)' after contralateral stimulation of the unaffected left median nerve, but not stimulation of the affected right median nerve. The mirror movements and motor recovery might have utilized an ipsilateral motor pathway between the unaffected hemisphere and the affected hand.
Asunto(s)
Mano/fisiopatología , Trastornos del Movimiento/etiología , Trastornos del Movimiento/fisiopatología , Accidente Cerebrovascular/complicaciones , Estimulación Magnética Transcraneal , Apraxia Ideomotora/etiología , Vías Eferentes/fisiopatología , Potenciales Evocados Motores , Potenciales Evocados Somatosensoriales , Femenino , Lateralidad Funcional , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Trastornos del Movimiento/patología , Paresia/etiología , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/fisiopatologíaRESUMEN
To investigate the effect of the selective serotonin reuptake inhibitor (SSRI) fluvoxamine on central poststroke pain (CPSP), fluvoxamine (25 to 125 mg daily) was given to 31 patients. Although 3 patients dropped out within 1 week, 28 patients who received fluvoxamine for 2 to 4 weeks showed a significant reduction in the visual analog scale (VAS) for pain from 7.7 +/- 2.2 to 6.0 +/- 3.4 (p < .01). This improvement in VAS was significant in patients within less than 1 year after stroke, but not in those with a duration of more than 1 year. Zung's Self-rating Depression Scale (SDS) was also significantly improved after treatment, but there was no significant correlation between the changes in VAS and SDS. Although this is not a double-blind, placebo-controlled trial, these results suggest that fluvoxarnine is useful for the control of CPSP regardless of depression when used relatively early after stroke.