摘要
目的探讨运动神经元病(motor neuron d isease,MND)常规节段运动神经传导和位移技术检测的特点。方法对162例MND患者和60名健康对照进行常规节段运动神经传导测定,同时对部分神经采用位移技术测定,并进行分析比较。结果(1)健康人常规节段运动神经传导测定显示:近端与远端比较,波幅和面积下降程度均小于20%,时限增宽小于15%;(2)在MND患者,常规节段测定共有76个节段(5.57%)波幅下降超过20%,45个节段(3.30%)面积下降超过20%,76个节段(5.57%)时限延长超过15%。仅有4例(2.5%)患者4条神经的4个常规节段(0.29%)达到运动神经部分性传导阻滞标准,但采用位移技术测定时均未达到短节段传导阻滞的诊断标准。结论在大部分MND患者常规节段运动神经传导测定正常,在部分患者也可以出现“传导阻滞样”的电生理表现,但其发生率极低,进一步采用位移技术测定有助于鉴别。
Objective To elucidate the features of segmental motor nerve conduction studies in a large sample of motor neuron disease （ MND）. Methods Two groups of subjects including 60 healthy controls and 162 patients with MND were recruited in 4 years. Standard segmental motor nerve conduction studies were performed in median nerves and ulnar nerves, and inching techniques were performed in some subjects simultaneously. The features of segmental motor nerve conduction studies in two groups were compared. Results （1） The normal limits across a standard segment estimated from healthy controls were a decrease in amplitude of 20% or less, a decrease in area of 20% or less, and an increase in duration of 15% or less. （2） The segments with a decrease in amplitude of 20% or more, a decrease in area of 20% or more and an increase in duration of 15% or more were detected in 5. 57%, 3.30%, 5. 57% of all the segments of nerves in patients with MND respectively. According to the criteria recommended by AAEM, 4 segments （0. 29% ） of 4 nerves in 4 patients （2. 5% ） with MND met the criteria of conduction block （CB） or probable CB, but no CB or probable CB was detected in these nerves with inching techniques. Inching technique showed that the decrease in amplitude across the segments in MND was gradually but not suddenly, the shorter between the stimulating site and recording site, the less the decrease in amplitude. Conclusions Standard segmental motor nerve conduction studies should be normal in most patients with MND; pseudo-CB might be detected in patients with MND, however, it might be rare. Inching technique should be helpful in differentiation.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第11期694-696,共3页
Chinese Journal of Neurology
关键词
运动神经元病
神经传导
Motor neuron disease
Neural conduction
