摘要
目的 探索磁刺激运动诱发电位 (MEP)在颈髓髓内和髓外病变中的诊断价值。方法 采用磁刺激MEP和电刺激F波相结合的方法 ,测定颈髓病变患者 45例 ,健康对照组 2 0例。通过记录双侧上肢外展拇短肌 (APB)和下肢胫前肌 (AT)的混合肌动作电位 ,计算中枢运动传导时间 (CMCT) ,并与临床表现和影像学表现作对比。结果 AT肌MEP检查结果对髓外病变较敏感 ,CMCT异常与颈髓压迫影像和上运动神经元受累表现相关。 5例 (1 1 1 % )患者发现CMCT的亚临床型病损。结论 在髓外病 ,AT肌CMCT较为敏感 ;CMCT异常与脊髓压迫影像和上运动神经元受累表现相关 ,MEP检查以对颈髓髓内和髓外病损均有重要诊断价值 ,甚至能发现亚临床型病损。
Objective To investigate the diagnostic value of magnetic stimulation Motor Evoked Potentials(MEP)in cervical spinal cord lesions was investigated in this prospective clinical study.Methods Forty-five patients with cervical spinal lesions,including cervical spondylosis (n=23),cervical spinal canal stenosis (n=6),cervical spinal and cord tumors (n=10) and syringomyelitis (n=6), and 20 normal controls person were also examined by transcranial magnetic stimulation.The central motor conduction time (CMCT) was calculated after compound muscle action potentials were recorded from the abductor pollicis brevis(APB) muscles and anterior tibia (AT) muscles bilaterally,together with F test from the same extremities.Correlations of abnormal CMCT with radiologically proved spinal cord compression and with clinical signs of upper motor neuron involvement were tested.Results Aomng 34 patients with extramedullary lesions, abnorma lCMCT to the APB was in 22 kevealed(64 7%)and to the AT in 24(70 6%).In 11 Patients with intramedullaty lesions,abnormal CMCT to the APB was revealed observed in 3 (27 3%)and to the AT in 3(27 3%).The sensitivity of CMCT to the AT in extramedullary disorders was significantly higher.Abnormal CMCT also highly correlated with spinal cord compression and with upper motor neuron involvement.Subclinical lesions were detected by an abnormal CMCT in 5 patients(11 1%).Conclusions In extramedullary lesions,measurement of CMCT to the AT is more sensitive.Abnormal CMCT correlates with spinal cord compression and clinical signs of upper motor neuron involvement,MEP has high diagnostic value in cervical cord lesions,which even can detect subclinical lesions.
出处
《武警医学》
CAS
2000年第7期387-389,共3页
Medical Journal of the Chinese People's Armed Police Force
基金
上海市医学领先专业重点学科基金!资助课题 ( 1995-Ⅵ - 0 0 8)
关键词
运动诱发电位
磁刺激
颈椎
颈髓病变
诊断
Motor evoked potentials Magnetic stimulation Cervical spine Cervical cord disorders