电刺激颏神经诱发三叉神经皮层电位的研究.docVIP

???? 电刺激颏神经诱发三叉神经皮层电位的研究 ???? ????【摘要】　目的　以电生理手段客观评价三叉神经的功能状态。方法　通过刺激18名健康成人颏神经，在T3、T4部位收集本侧及对侧的三叉神经诱发电位(TSEP)。结果　①在刺激发生16ms左 右，出现第一个阳性波即P1，依次为N1～N5等10个波峰；②其中P3，N3，P4，N4潜伏期较为 稳定，N3～P4为一个陡降的高振幅波且形稳定；③对于刺激的反应，在同一个体双侧具有 同等的程度；④波幅随刺激强度的加大明显增高。结论　各波的潜伏 期、形特点、峰峰电位差并结合形整体形态及参数可以作为临床判定TSEP的指标。　　【关键词】　诱发电位　　三叉神经　　颏神经　　电刺激 The study of trigeminal somatosensory evoked potentials by electric stimulating mental nerve Wang Yushen　Liu Wen　Lu Jianhui　et al（Stoma tological College,Tianjin Medical University,Tianjin,300070） 　　【Abstract】　Objective　In order to evaluate trigeminal nerve response.Methods　Trigeminal somatosensory evoked potentials (TSEPs) were recorded in eighteen healthy adults by electric stimula ting mental nerve of both sides.Results　The first positiv e peak (P1) appeared at 16ms after stimulation,then the other nine peaks from N1 to N5 in succession.In these peaks,the latencies of P3,N3,P4,N4 were stabel,the amplitude of N3～N4 developed perpendicular decline and great extent.With enhan cing of the stimulation,the latency would be shortened and the amplitude height ened.It was appropriate to achieve a model wave by stimulating with three-times threshold.The rdlative ratios between two sides were 0.33～0.54 in laten cies and 0.37～0.76 in amplitudes (P＞0.05).Conclusion　 These result indicate that the responses of both sides are almost sam e in one person.All of these suggest that the latency,spike potential,feature and shape of wave would be the parameters to evaluate TSEPs.　　【Key words】　Evoked potential　　Trigeminal nerve　　Mental nerve　　Electric stimulation 　　外伤、肿瘤等疾病可致三叉神经感觉障碍［1］,其程度仅依 靠病人的自述，难以正确评价三叉神经功能状态、疗效及预后。为此作者参照国外有关文献 ［1～6］，结合临床应用的可行性，进行了电刺激颏神经诱发三叉神经皮层电位的研 究。 材料和方法 　　试验对象及方法：22～56岁健康成人18名，男性10名，女性8名，口颌系统检查无明显异常，颌面部感觉无障碍，无颌骨、颅脑手术、外伤史，向受试者说明检查方法避免 其紧张，于屏蔽室内，暗光安静环境内平卧，轻闭目。检查中嘱受试者精力集中默数刺激次 数，下颌放松保持息止颌位，避免咬牙及吞咽。刺激电极为5mm×10mm银板电极，负极置于 第一、二双尖牙根尖部位相对的皮肤处，正极置于其后15mm。首先以5mA刺激强度使受试者 感知刺激性质，再自0mA缓慢加大刺激量，直至受试者感知刺激存在，作为阈值刺激。刺激 电流为100μs方波，刺激间隔5～10mes。记录电极为8mm脑电用银盘电极，记录电极