Cortical magnetic stimulation was performed in a consecutive series of
10 patients presenting within 15 days of traumatic spinal cord injury
. In those patients with complete paraplegia or quadriplegia, motor ev
oked potentials at presentation were absent below the level of the les
ion. Six months after the injury, potentials had returned in the bicep
s brachii and abductor pollicis brevis muscles in some quadriplegic ca
ses, but remained absent from the tibialis anterior in all of this gro
up. None of those with a complete lesion made a significant functional
recovery. Of the three patients with incomplete quadriplegia, two sho
wed a significant recovery after 6 months. Motor evoked potentials wer
e recordable below the level of the lesion at presentation in these ca
ses, although the latencies were prolonged. In the remaining patient w
ho failed to improve, potentials were unrecordable throughout the stud
y. This small pilot study suggests that cortical magnetic stimulation
may be useful in refining the prognosis in patients with an incomplete
spinal cord injury.