摘要
目的 探讨不同年龄期儿童周围磁运动诱发电位 (magneticmotorevokedpotential,MMEP)的年龄特征与发育规律。方法 对 2 5 7名 0～ 14岁健康儿童应用磁刺激分段测试 [第 7颈椎 (C7)、第4腰椎 (L4 )、肘和窝 ]周围运动传导通路功能 ,分别在上肢拇短展肌和下肢足母展肌处记录 ,获得各年龄期MMEP各项参数和发育特征。结果 除部分幼婴儿因磁线圈放置困难外 ,在各年龄组正常小儿(包括新生儿 )的上、下肢均可记录到清晰、重复性良好的周围性MMEP反应波。各年龄组上下肢左、右间潜伏期差值较稳定 ,最大值均不超过 2 .2ms。上、下肢校正潜伏期分别于 2岁和 1岁时达成人值的 1/ 2 ,下肢校正潜伏期和周围传导速度在 4岁时先于上肢 (6岁 )达成人水平 ,且上、下肢周围运动神经近段传导速度较远段快。运动神经传导速度以周围段最快 ,脊髓次之 ,颅内最慢。结论 (1)婴幼儿是人类周围运动神经传导功能发育的关键年龄期 ;(2 )周围运动神经系统发育遵循由近段及远端 ,先下肢后上肢的规律 ;(3)磁刺激无痛无创可安全地用于包括新生儿在内的各年龄段小儿周围运动神经功能的检测 ,尤其磁刺激能直接诱发神经根段电位 ,对周围神经病的诊断 。
Objective To explore the characteristics and developmental changes of peripheral magnetic motor evoked potential (MMEP) in children of different age groups, to improve the test for the easy application in the diagnosis of neuromuscular diseases in children.Methods Two hundred and fifty seven children aged from 0 to 14 years, without any neurological and developmental problem,were divided as follows: neonate, ～6 m, ～1 y, ～2 y, ～4 y, ～6 y, ～8 y, ～10 y and ～14 y, as age groups and 20 healthy adults as the control group. MMEP along peripheral motor conduction pathways(C 7, L 4, elbow and popliteal fossa)were tested by using the magnetic stimulation. The peripheral MMEPs at the abductor pollicis brevis (APB) and the abductor hallucis (AH) were recorded, respectively, and their maturation in children were analyzed.Results Clear and well reproducible MMEPs were recorded at APB and AH muscles in all children except some neonates to whom it was difficult to place the magnetic coil. The differences of latencies between the left and right sides, either upper or lower extremities, were quite stable with the upper limitation less than 2.2 ms in all age groups. The correct latencies at the upper and lower extremities were the half of adult values before 2 and 1 year of age, respectively. Peripheral conduction velocities (PCVs) and correct latencies at the lower extremity reached the adult values at 4 years, which were earlier than those at the upper extremity at 6 years. The PCVs at the proximal segment of upper or lower extremity were all quicker than those at the distant. There were different maturational paces along the motor nerve conduction pathway,PCVs along peripheral pathway were always the fastest, and then the spinal cord, finally the encephalic segment. Conclusion (1) It is the crucial time in infantile period for the maturation of the conduction function along the peripheral motor nerve system. (2) The development of the peripheral motor nerve system followed a regular pattern, nam
出处
《中华儿科杂志》
CAS
CSCD
北大核心
2001年第8期461-464,共4页
Chinese Journal of Pediatrics
