神经肌电图的临床应用__培训课件.pptVIP

Visual E.P. Optic Nerves and Stimulus Optic Nerve Optic tract Lateral geniculate body Occipital lobe Pattern : Checkers - Bares Goggles Flash Visual E.P. O1-Cz Oz-Cz O2-Cz Cz-A1 P100 N75 N145 N100 VER Right eye 100 200 ms Oz O1 O2 Oz Cz 70 cm A1 Stim. : Checker Checker size : Visual angle * Stim. Freq. : Max. 2 Hz Dark room Averaging : 200 - 300 AVG Sens. : 5 to 10 μV/D * See this term in Technical section Auditory E.P. Brain Stem I Distal spiral ganglia and auditory nerve II Proximal auditory nerve (cochlea nucleus) III Ventral cochlear nucleus in pons IV Inferior lateral lemiscus in pons V Lateral lemiscus in lower mid brain VI Medial geniculate nucleus (upper mid-brain) VII Primary auditory cortex I II III IV V VII VI Stimuli Stimulation: threshold + 70 dB SPL * Unfiltred Click 50 - 100 μs Above 120 dB Max. : 132 dB I II III IV V V I V II ! * See this term in Technical section BAEP的记录原理 Auditory E.P. BAEP BAERs Right A2-Cz I II III IV V V I Normal Values Latences Amplitudes Peaks ms SD μV SD I 1.7 0.15 0.28 0.14 II 2.8 0.17 0.23 0.12 III 3.9 0.19 0.25 0.12 IV 5.1 0.24 0.40 0.13 V 5.7 0.25 0.47 0.16 VI 7.3 0.29 0.43 0.16 A1 A2 Cz Left Right 5 10 ms Stim. : Click 50 μs Averag. : 2000 - 4000 AVG Sens. : 0.1 μV/D I.O.M. Intra Operating Monitoring Monitoring during critical phases of operation Physiologic potentials and responses are affected by : . Anesthesic Drugs No EP Responses in the Brain . Curare No Motor Responses Always perform EP Tests before operation for : . Correct place of electrodes .