摘要
目的为脊髓损伤(spinal cord injury,SCI)的法医临床学鉴定寻找客观且准确的检查方法。方法采用经颅磁刺激运动诱发电位(transcranial magnetic stimulation-motor evoked potential,TMS-MEP)测定68例SCI患者(颈段损伤23例,胸腰段损伤45例)拇短展肌和胫前肌的皮层起始潜伏期、N1峰潜伏期、中枢运动传导时间(central motor conduction time,CMCT)和波宽,并以30例正常人作为对照,比较两组差异。结果实验组随拇短展肌、胫前肌肌力下降或消失,皮层起始潜伏期、N1峰潜伏期、CMCT延长,波宽增宽,且实验组中的2、3级肌力者上述指标均高于对照组(P<0.05)。结论 TMS-MEP检测可以直接、客观地反映脊髓锥体束的运动功能状态,为法医学鉴定提供更客观、准确的依据。
Objective To find an objective and accurate examination for evaluation of spinal cord injury （SCI） in forensic clinical medicine. Methods The onset latency of cortex, peak latency of N1, central motor conduction time （CMCT） and wave width of the abductor pollicis brevis and the anterior tibialis were calculated by transcranial magnetic stimulation-motor evoked potential （TMS-MEP）. The data of 68 patients suffered from SCI including 23 cervical levels and 45 thoracolumbar levels were collected and compared with that of 30 normal controls. Results In experimental group, when the muscle strength of the abductor pollicis brevis or the anterior tibialis decreased or disappeared, the onset latency of cor- tex, the peak latency of N1, and CMCT prolonged and the wave width broadened. And these indexes of grade 2 and 3 muscle strength in experimental group were higher than that in the control group （P〈0.05）. Conclusion The TMS-MEP can determine directly and objectively the motor functional status of pyramidal tract of spinal cord in order to provide more accurate and objective evidences in forensic medicine.
出处
《法医学杂志》
CAS
CSCD
2013年第3期172-175,共4页
Journal of Forensic Medicine
关键词
法医学
脊髓损伤
诱发电位
运动
经颅磁刺激
forensic medicine
spinal cord injury
evoked potentials, motor
transcranial magnetic stimulation
