胫后神经体感诱发电位对头颅CT阴性脑硬塞病人临床价值研究.pdf

觉中枢或感觉传导通路部位的脑梗塞患者的SEP异常率高， 而小脑梗塞、颜叶、枕叶等梗塞SEP异常率低。21例患者2 月后复查SEP，其中6例两次均为重度异常者，其肋体肌力 仅由。级恢复至工级，4例由重度异常恢复至中度异常，其病 侧肢体肌力增加II、工II级;8例首次SEP为轻中度异常者， 复查SEP恢复至轻度异常或正常，相应的肢体肌力也有所恢 复。卜 结论:对于早期头颅CT未显影的脑梗塞病人，胫后神经SEP 可出现波形异常，胫后神经SEP对大脑皮层中央后回上部及 其传导通路受损的脑梗塞、早期头颅CT阴性时有辅助诊断价 值;间隔一定时间复查SEP,SEP的恢复与肢体功能恢复相一 致，因此SEP对脑梗塞的肢体功能恢复有一定判断价值。 关键词:胫后神经 体感诱发电位 脑梗塞 StudyoftheClinicalValueofSomatosensoryEvoked PotentialofPosteriorTibialNervetoPatientsofEarly CerebralInfarctionwithNegativeSkullCT Abstract Objective:Tostudythesignificanceofposteriortibialnerve somatosensoryevokedpotential(SEP)tothediagnosisofcerebral infarctionwithnegativeskullC工andtoassessitsvaluetothe recoveryofthepatientslimbfunctionwithcerebralinfarction. Materialsandmethods:39casesofcerebralinfarctionwhowere diagnosedwithin24hoursnegativebyskullCTwereselected, amongwhom24aremalesand15arefemales.Theaverageageof themis59.018.2.ThesepatientsreceivedexaminationwithSEP, andanother40normalpersonswereinvolvedintheexperimentas controlgroup.Assoonasthediseaseoccurred,allthepatients received skullCT examinationandSEP examination in the posteriortibialnervein24hours.Threedayslater,skullCTwas re-examinedforallthepatientsand2monthslater,tracingre- examinationofSEPwasperformedfor21patients.Thedisease occurredforthefirsttimetoallthepatientsandtheyhadneither centralnervesystemdiseasenorsurroundingnervesystemdisease inthepast.CranualCTexaminationindicatednidusonthesingle side.Amongallthecases7hadcerebrallobeinfarction,4had thalamusinfarction,2hadbrainsteminfarction,1hadcerebellum infarction,15basalgangliainfarctionand10coronaradita infarction.Myodynamiaanddegreeofsensorydisturbancewere recordedsimultaneously,andtheresultsofboththeanteriorand posteriorexaminationswerecompared.Neuromuscular electricity-evokedpotentiometerKeypointproducedbyDames CorporationwasusedtoperformSEPexamination.Accordingto theinternationalEEG10/20system,P40,N50,P60andN75were recordedi