Usefulness of transcranial magnetic stimulation to predict the development of reflex sympathetic dystrophy poststroke: a pilot study.

OBJECTIVE

To investigate the predictive value of transcranial magnetic stimulation (TMS) for the development of reflex sympathetic dystrophy (RSD) poststroke.

DESIGN

Blind clinical assessment of 2 groups of stroke patients defined on the basis of absent or preserved motor evoked potentials (MEPs) on the affected side.

SETTING

Stroke rehabilitation center.

PATIENTS

Twenty stroke patients between the ages of 41 and 85 years, undergoing rehabilitation.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

MEPs from upper limbs 30 days poststroke, Motricity Index, and scoring of RSD using the Enjalbert Scale 73 days poststroke.

RESULTS

A good correlation was found between Motricity Index and TMS results (P<.01). Average Enjalbert scores were significantly different between the 2 groups (P=.03). No significant correlation was found between Enjalbert scores and the Motricity Index.

CONCLUSIONS

Although no significant relationship was found between upper-limb motor impairment and intensity of RSD 10 weeks after stroke, the TMS responses permitted the early categorization of patients into 2 groups that developed significantly different average Enjalbert scores 1 to 2 months later when this clinical condition was fully developed.