Transcranial Magnetic Stimulation Excites the Root Exit Zone of the Facial Nerve

Tokimura, Hiroshi; Yamagami, Masayuki; Tokimura, Yoshika; Asakura, Tetsuhiko; Atsuchi, Masayuki

doi:10.1227/00006123-199303000-00012

Cited by 21 publications

(8 citation statements)

References 7 publications

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“…There is some evidence that when using transcranial magnetic stimulation the peripheral seventh nerve is stimulated directly without conduction through the central motor pathway from the cortex (17,(19)(20)(21). C3-C4 stimulation always caused bilateral facial MEP responses; the side of dorsal interosseous and tibialis anterior MEP responses were dependent on the current direction.…”

Section: Discussionmentioning

confidence: 99%

“…It has previously been found that the latency in transcranial magnetic stimulation of peripheral facial nerve responses was approximately 5 milliseconds (17,(19)(20)(21). This corresponds to the latency of the recorded ipsilateral facial CMAP cause by a single-pulse stimulus.…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, MEPs are used to monitor the motor component of the long tracts in the brainstem and spinal cord, and potentially useful information regarding cranial nerves has not been used. There has been concern regarding the site of stimulation of the facial nerve using transcranial magnetic stimulation (17,19,20,21); this does not appear to be a problem with localized contralateral transcranial electrical stimulation using our methods. A novel technique using MEP for the evaluation and monitoring of cranial nerves (primarily the facial nerve) during cranial base surgery on a consecutive series of patients is presented.…”

mentioning

confidence: 97%

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Localized Transcranial Electrical Motor Evoked Potentials for Monitoring Cranial Nerves in Cranial Base Surgery

Akagami

Dong

Westerberg

2005

Operative Neurosurgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

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Localized Transcranial Electrical Motor Evoked Potentials for Monitoring Cranial Nerves in Cranial Base Surgery

Akagami

Dong

Westerberg

2005

Operative Neurosurgery

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“…Schmid et al [16] suggested that the short-latency response results from stimulation of the facial nerve in its intracisternal part, presumably 10 mm after its entrance into the stylomastoid foramen. Tokimura et al [19] described stimulation at the root entry zone and therefore assumed an investigation benefit of TMS in cerebellopontine angle tumors.…”

Section: Discussionmentioning

confidence: 99%

Perioperative lesions of the facial nerve: follow-up investigations using transcranial magnetic stimulation

Kotterba

Tegenthoff

Malin

1997

Eur Arch Otorhinolaryngol

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Peripheral facial palsy can occur after aural surgery and neurosurgery. Routine neurophysiological investigation (utilizing electrical stimulation and the blink reflex) does not allow the direct assessment of the site of a lesion. In the present study transcranial magnetic stimulation (TMS) was applied in order to evaluate the usefulness of this method for prognosis. Twenty-three patients with postoperative facial pareses (after removals of an acoustic neuroma in 12 patients and parotid tumors in 11) were investigated. Ipsilateral short-latency and contralateral long-latency responses (after cortex stimulation) were elicited. At the first examination (11.7 +/- 9 days after onset of the palsy) the components of the blink reflex were absent in all cases. Responses to electrical stimulation were abnormal in 80%. Ipsilateral short-latency responses after TMS could be obtained in 7 patients. Pathological long-latency TMS responses were elicited in 17 patients. Follow-up investigations up to 2 years revealed no prognostic aspects from peripheral electrical stimulation, the blink reflex and the short-latency TMS response. The absence or extent of delay in long-latency responses at first examination was strongly correlated with final clinical outcomes. As improvements of the responses preceded clinical regressions of the paresis, TMS proved to be an important neurophysiological method for an early prognosis of recovery after perioperative lesions of the facial nerve.

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“…Eventually, scientists and clinicians began focusing on the evolution and possible clinical applications of the transcranial magnetic stimulation system in facial nerve disorders. 2,3,16–28 …”

Section: Introductionmentioning

confidence: 99%

Transcranial Magnetic Stimulation in Acute Facial Nerve Injury

Har‐El¹,

McPhee²

2000

The Laryngoscope

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Objective/Hypothesis Available electrodiagnostic tests that are used to evaluate facial nerve injury examine the nerve distal to the stylomastoid foramen; because most facial nerve injuries are within the temporal bone, the tests cannot evaluate the nerve at or across the injury site. The interpretation of these tests depends on the predictability (or unpredictability) of distal degenerative process. Transcranial magnetic stimulation may be able to stimulate the nerve proximal to the injury site. The hypothesis of the present study is that in cases of mild traumatic facial nerve injury where axonal integrity is maintained, proximal stimulation of the nerve using higher than normal stimulus intensities to “overcome” the block at the injury site result in recordable facial nerve activity. Study Design A prospective controlled animal study comparing response to transcranial magnetic stimulation of the facial nerve in the following groups: mild injury, severe injury/transection, and control. Methods We studied 44 facial nerves in 22 cats. Fifteen nerves were subjected to mild trauma. Five nerves were severely crushed, 2 nerves were completely transected, and 22 nerves were not traumatized. All nerves were examined with the transcranial magnetic stimulation system before the trauma, immediately after the trauma, and at 3, 8, and 12 weeks after trauma. Results All nerves in the mild and severe trauma groups showed complete clinical paralysis immediately after trauma. The nerves in the mild trauma group showed significant increase in threshold as well as significant increase in latency for recordable facial muscle response to transcranial magnetic stimulation. Thresholds and latencies decreased gradually within 3 to 12 weeks and returned almost to preinjury levels. This paralleled the return of clinical facial muscle movement. In the severe trauma/transection group, the nerves had no facial muscle response to transcranial magnetic stimulation after trauma. Neither facial muscle response to transcranial magnetic stimulation nor facial muscle movements recovered. Conclusions In cats transcranial magnetic stimulation can assess the integrity of the facial nerve after trauma and predict its potential for regeneration. This technique can excite the nerve proximal to the injury site and may play a role in the clinical evaluation of the acute traumatic facial nerve paralysis. It can be used immediately after trauma, because it does not depend on wallerian degeneration to occur.

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Transcranial Magnetic Stimulation Excites the Root Exit Zone of the Facial Nerve

Cited by 21 publications

References 7 publications

Localized Transcranial Electrical Motor Evoked Potentials for Monitoring Cranial Nerves in Cranial Base Surgery

Localized Transcranial Electrical Motor Evoked Potentials for Monitoring Cranial Nerves in Cranial Base Surgery

Perioperative lesions of the facial nerve: follow-up investigations using transcranial magnetic stimulation

Transcranial Magnetic Stimulation in Acute Facial Nerve Injury

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