ABSTRACT
There is still controversy about the prognostic value of motor evoked potenials [MEPs] in the assessment of hemiplegia. In order to underst and the role of TMS in studying the integrity of corticospinal tract we have performed such study on Patients with first ever established is-chemic stroke in the domaine of MCA territory, their age ranged from 17-82 years with a mean age of 61.8 + 31.1 years. Functional recovery was assessed by using Sc and inavian Neurological Stroke Score [sss], the Barthed Activities of Dialy Living Index [BI], and the motor score to assess the motor function status of upper and lower limbs. Electrophysiolgical assessment by using TMC to both first dorsal interosseous [FDI] and Tibials anleiror [TA] muscles. These assessments were carried out at the same time in 2 sessions, the first session was within 3 days from the onset of the symptoms and the second was 14 days later. At the first session, MEP was elecited from FDI in the hemiplegic side in 36% and from TA of the same side in 48%. CMCT of these patients was significantly prolonged compare to the healthy side of the same patient. On the second session, there was no significant shortening of the CMCT to FDI and TA. There were inversed correlation between CMCT to TA with sss [r = 0.6]. From this work we conclude that, early performed transcramial magnetic stimulation is a valuable prognostic tool for motor recovery from stroke