科内讲座：肌电图基本知识及主要用途PPT课件.ppt

* 一例34岁男性患者，临床上表现为选择性足背屈力弱和下背部疼痛并放射至对侧小腿。神经传导检测显示为在膝部刺激的两个点（b’和b）之间的传导阻滞，也就是说病变部位在b’和b之间。b’点为病变远侧的刺激点、b和c点为病变近侧的刺激点。当病人摒弃“习惯性小腿交叉”这一动作后，无力很快就消失了。（引自Kimura J, 1989） * Fig.12 Guillain-Barré syndrome. Note the distal conduction block (A), loss of F waves (asterisk) and presence of M-satellites (arrows) (B).传导阻滞 F波丧失 出现M卫星电位 * 一例31岁的格林巴利患者，在肘部和腕部刺激尺神经，双侧小指展肌CMAP的潜伏期均延长、波形离散。在同一刺激部位，连续检测四次，波形基本相似，说明了结果的一致性良好。在踝和膝部刺激胫神经，也有类似的发现。（引自Kimura J, 1989） * Fig.15 Conduction block in median motor nerve in a case of MMN (A). The sensory conduction studies show normal condition (B). * 左Acquired demyelinating neuropathy. ? CIDPolyradiculopathy. ? Motor neuropathy with multifocal conduction blocks. Figure 1. Motor-Nerve Conduction Study of the Left Median Nerve (Left Abductor Pollicis Brevis). The wave forms were obtained by supramaximal stimulation of the left median nerve at the wrist, elbow, axilla, and eighth cervical and first thoracic spinal roots (neck) and were combined by a collision technique to isolate the contribution of the eighth cervical and first thoracic spinal roots to the median nerve (see text). Stimulation at the wrist elicited a well-synchronized compound muscle response of normal amplitude. Stimulation at the elbow, axilla, and cervical roots produced a markedly dispersed, low-amplitude compound muscle response, probably caused by demyelinating lesions in the forearm. 右Figure 1. Diagnostic Findings in Chronic Inflammatory Demyelinating Polyneuropathy. Panel A shows a partial motor-nerve conduction block and abnormal temporal dispersion in a nerve-conduction study, with a reduction of compound muscle action potentials from the abductor digiti minimi muscle after ulnar nerve stimulation at the elbow (bottom), as compared with the amplitude after stimulation at the wrist (top). Axial T1-weighted MRI scans of the lower thoracic spine, shown before the administration of gadolinium in Panel B and after the administration of gadolinium in Panel C, reveal strong