急性脊髓炎脑诱发电位的研究

目的；探讨脑诱发电位(BEP)在诊断急性脊髓炎阿多发性硬化关系中的作用。方法：对28例急性脊髓炎患进行了3种BEP检查，对其结果同正常对照值比较。结果：sEP异常率为90％，VEP异常率为52％．AEP异常率20％。其潜伏期值同正常对照值比较显延长(P<0．02)。结论：对急性脊髓炎患做BEP检查有助于多发性硬化的早期诊断，     

诱发电位及核磁共振对多发性硬化诊断价值比较研究

对３０例多发性硬化（ＭＳ）患者通过检查视觉诱发电位（ＶＥＰ）、脑干吸觉诱发电位（ＢＡＥＰ）、体感诱发电位（ＳＥＰ）及核磁共振（ＭＲＩ）,分析其异常率,发现ＶＥＰ、ＢＡＥＰ、ＳＥＰ及ＭＲＩ的异常率分别为９２．８％、８５．６％、８９．３％、６６．７％。经统计学分析,诱发电位及磁共振在ＭＳ的检查上二者存在明显差异,诱发电位对ＭＳ的诊断更具有实用价值。     

单光子发射计算机断层显像对儿童癫痫病诊断价值的探讨

目的：研究单光子发射计算机断层显像（ＳＰＥＣＴ） 在癫痫病诊断中的应用价值并与癫痫发作间期ＥＥＧ 对照。方法：对７０ 例癫痫发作间期患儿进行ＳＰＥＣＴ 检查，结果对三维图像进行目测分析，连续２ 个以上层面出现放射性显示ｒＣＢＦ明显减少者为阳性。结果：７０ 例癫痫患儿发作间期（ 发作７２ｈ 后） 检查，显示脑血流灌注减低５８ 例，异常率８２－８５ ％ （５８／７０） 。ＥＥＧ 检查，７０ 例癫痫发作间期患者脑电图异常２５ 例，异常率３５－７１ ％ （２５／７０） 。ＳＰＥＣＴ 脑血流显像，在癫痫发作间期阳性率高于ＥＥＧ 的阳性率，两者相比，Ｐ＜ ０－００５ ，差异非常显著。结论：对发作间期病人ＥＥＧ 或２４ｈ 动态脑电图阴性的癫痫患者ＳＰＥＣＴ 可作为补充检查，以提高阳性率，为癫痫病诊断进一步提供可靠依据。     

多发性硬化的诱发电位检查

我们对１９９３年４月～１９９８年６月收治经临床诊断为多发性硬化（ＭＳ）的５４例患者，未经筛选进行了视诱发电位（ＶＥＰ）、脑干听觉诱发电位（ＢＡＥＰ）、体感诱发电位（ＳＥＰ）检查，其结果报告如下，旨在评价ＥＰＳ在ＭＳ诊断中的重要意义，使之更有效地应用于...     

脑出血患者脑干听觉诱发电位与脑血流量相关性研究

目的：研究高血压脑出血患者脑干听觉诱发电位（ＢＡＥＰ）与脑血流量（ＣＢＦ）的相关性。方法：检测８３例高血压脑出血患者和７５例正常人的ＢＡＥＰ及用１３３Ｘｅ吸入法测定ＣＢＦ。结果：脑出血患者ＢＡＥＰ和ＣＢＦ异常率分别为６９．９％和６３．９％，病情愈重则异常率愈高，脑出血量大者ＢＡＥＰ和ＣＢＦ异常率高于出血量少者，Ｐ＜０．０５～０．０１。脑出血患者ＢＡＥＰ主波潜伏期和波间期均比正常对照组明显延长，Ｐ＜０．０５～０．０１；ＢＡＥＰ异常患者ＣＢＦ明显低于ＢＡＥＰ正常患者，Ｐ＜０．０５～０．０１。结论：ＢＡＥＰ是评估脑出血患者脑干功能和脑血流量的良好手段。     

118例糖尿病患者的体感诱发电位研究

方法：对已确诊Ⅱ型（非胰岛素依赖型）糖尿病的１１８例患者进行了体感诱发电位（ＳＥＰ）观察。结果，ＳＥＰ正常２８例（２３．７％）异常９０例（７６．３％），其异常发生率与年龄，血糖控制情况有显著相关性，即年龄大，病程长及长期血糖控制差的患者ＳＥＰ异常率高，结果还显示，有神经系统症状的患者ＳＥＰ多为异常，而临床尚未出现神经系统症状者ＳＥＰ也可出现异常改变，结论：该检查对糖尿病性神经病变的早期诊断有一定的     

30例多发性硬化患者视诱发电位检测

目的研究视诱发电位（VEP）异常与多发性硬化症的关系。方法对临床确诊的30例多发性硬化患者和30例神经内科诊断为非多发性硬化症患者进行VEP检查，并分析VEP的检查结果与临床症状间的关系。结果多发性硬化患者VEP检查的异常率为76．7％。而82．6％的VEP异常者在临床上表现出视觉症状。结论多发性硬化患者的VEP检查中有较高的异常率，对多发性硬化的诊断有参考价值。     

单光子发射计算机断层显像对儿童癫痫病诊断价值的探讨

目的：研究单光子发射计算机断层显像（ＳＰＥＣＴ）在癫痫病诊断中的应用价值并与癫痫发作间期ＥＥＧ对照。方法：对７０例癫痫发作间期必进行ＳＰＥＣＴ检查,结果对三维图像进行目测分析,连续２个以上层面出现放射性显示ｒＣＢＦ明显者为阳性结果：７０例癫患儿发作间期（发作７２ｈ后）检查,显示脑血流灌注减低５８例,异常率８２．８５％。ＥＥＧ检查,７０例癫痫发作间期脑电图异常２５例,异常率３５．７１％。ＳＰＥＣＴ脑     

视神经脊髓炎和经典多发性硬化电刺激诱发瞬目反射的对比

目的：观察视神经脊髓炎型和经典多发性硬化型患者电刺激诱发瞬目反射的差异。方法：多发性硬化患者为河南省人民医院1996—01／2005—06门诊随诊及住院的临床确诊病例49例。健康对照组为河南省肿瘤医院及河南省人民医院健康体检人员及部分工作人员47例，多发性硬化组又分为视神经脊髓炎型（n=21）和经典多发性硬化型（n=28）。瞬目反射检查方法采用诱发电位仪，用表面电极刺激和记录，记录电极置于眼轮匝肌外侧，左右两侧对称，参考电极置于鼻骨两侧，接地电极置于颌部，刺激电极放在眶上切迹处。双导同时记录刺激侧所见的早反射和晚反射及对侧的晚反射。测定其潜伏期和波幅。双侧进行，共测4次，计算出瞬目反射各波的平均潜伏期和波幅。异常瞬目反射的判定标准：①各波潜伏期超过正常高限（x^-＋2．5s）（早反射11．5ms，晚反射38．8ms，对侧的晚反射40．1ms）和／或波幅低于正常低限（x^- -2．5s）（早反射62．5μV，晚反射43．0μV，对侧的晚反射7．0μV）。②除外操作错误、仪器故障和患者不合作等因素，瞬目反射未引出者为异常。神经功能缺损程度按EDSS进行评分。结果：49例多发性硬化患者和47例正常对照均完成检查，全部进入结果分析。①视神经脊髓炎型患者发病年龄、EDSS评分均显著高于经典多发性硬化型患者（P〈0．01）。②视神经脊髓炎型和经典多发性硬化型瞬目反射各波潜伏期均较对照组显著延长（P〈0．01～0．001），经典多发性硬化型患者的瞬目反射各波潜伏期与视神经脊髓炎型相比也显著延长（P〈0．01～0．001）；经典多发性硬化型患者的瞬目反射各波波幅与对照组和视神经脊髓炎型相比显著降低（P〈0．01～0．001），视神经脊髓炎型患者的瞬目反射各波波幅与对照组相比差异无显著性意义（P〉0、05）。③经典多发性硬化型患者的瞬目反射各波异常率均显著高于视神经脊髓炎型（P〈0．001）。结论：视神经脊髓炎型和经典多发性硬化型是多发性硬化的两种不同的临床类型：瞬目反射的改峦可反映脑干病蛮的部位和范围。     

脑诱发电位在诊断亚临床型肝性脑病的价值

目的：评价脑诱发电位（ＥＰ）诊断亚临床型肝性脑病（ＳＨＥ）的价值。方法：对４８例肝炎后肝硬化患者进行三种ＥＰ检查,并追踪１年观察临床肝性脑病（ＨＥ）出现情况。结果：三种脑诱发电位总异常２６例（５４％）,其中听觉诱发电位（ＢＡＥＰ）异常１８例（３８％）、视觉诱发电位（ＶＥＰ）异常３例（６％）、体感诱发电位（ＳＥＰ）异常１０例（２１％）,以ＢＡＥＰ异常高。追观察１年的２９例患者中,１５例ＥＰ异常者出现     

脑白质疏松症的诱发电位研究与血管因素的相关性

目的:探讨诱发电位对脑白质疏松症(leukoaraiosia,LA)的临床诊断价值及与血管因素的相关性。方法:选择45例经颅脑CT或MRI证实的单纯LA患者及部分伴有脑梗死的患者,并以60名正常健康老年人作对照,进行体感诱发电位(SEP)、脑干听觉诱发电位(BAEP)、脑干视觉诱发电位(VEP)检测。结果:LA患者中,SEP总异常率95.6%,其潜伏期和波幅均较对照组明显升高(P<0.05);BAEP总异常率71.1%,其各波潜伏期和峰间期较对照组明显延长(P<0.001);VEP总异常率64.4%,其各波潜伏期较对照组延长显著(P<0.001)。3种诱发电位的时间参数及波幅的异常率及异常程度均随LA的病损程度的加重而增加。LA并脑梗死患者3种诱发电位的异常率及异常程度明显高于单纯LA组。结论:在LA的临床早期,虽然还未出现典型的临床表现,但脑电生理已出现异常,诱发电位的检测可以作为早期诊断该病的一个敏感的辅助检测方法。LA并脑梗死患者诱发电位的异常率及异常程度明显高于单纯LA组,提示LA与血管因素有明显相关性。     

军人创伤后应激障碍与适应障碍的视觉和听觉诱发电位研究

目的 探讨军人创伤后应激障碍和适应障碍的视觉诱发电位和听觉诱发电位的特征。方法 对33例创伤后应激障碍患者和34例适应障碍患者及30名健康军人(对照组)，应用Nicolet Bravo型脑电生理仪及光、声刺激，完成视觉诱发电位和听觉诱发电位检测。结果 应激障碍组和适应障碍组Cz脑区视觉诱发电位／P2波幅较对照组为低，应激障碍组Pz脑区视觉诱发电位／P3波幅分别较对照组和适应障碍组为低；应激障碍组Oz脑区听觉诱发电位／P3潜伏期较对照组延迟，Cz脑区听觉诱发电位／P2波幅分别较对照组和适应障碍组为低，Cz脑区听觉诱发电位／P3波幅分别较对照组和适应障碍组为高。结论 应激障碍和适应障碍的诱发电位有一定的特征，值得进一步随访观察。     

糖尿病视网膜病变的视觉诱发电位及相关因素分析

目的探讨糖尿病视网膜病变(DR)的视觉诱发电位(VEP)表现,评价VEPP100在糖尿病视网膜病变早期诊断中的作用及VEPP100异常与神经传导速度(NCV)、体感诱发电位(SEP)改变的相关性。方法根据是否合并DR将64例糖尿病人分为两组均行VEP、NCV、SEP检测,VEP与正常组对照。结果26例合并DR的糖尿病人及38例正常眼底的糖尿病人的VEPP100分别与正常人比较,VEPP100潜伏期:与正常组比较均无明显差异(P>0.05);VEPP100波幅:较正常组均明显降低(P<0.05)。糖尿病VEPP100异常与NCV、SEP无相关性(r=0.076,P>0.05;r=0.075P>0.05)。结论DR的VEP表现以VEPP100波幅降低为主;VEP检测可为临床早期诊断DR提供依据。     

Early detection of neurological involvement in IDDM and NIDDM. Multimodal evoked potentials versus metabolic control

Clarification of the extent and mechanisms of damage to the central nervous system in diabetes is a frontier of current neurological research. Our aim was to obtain ample electrophysiological documentation of possible neurological abnormalities in both insulin-dependent (IDDM) and non-insulin-dependent (NIDDM) diabetic patients with a short duration of disease and without overt complications, taking into account metabolic control. Group 1 comprised 11 IDDM patients, and group 2 included 14 NIDDM patients treated with diet alone; the duration of disease was less than 4 yr, and no concomitant clinical complications were present. Age- and sex-matched normal subjects formed groups 3 and 4. Pattern visual evoked potentials (VEP), brain stem auditory evoked potentials (BAEP), and somatosensory evoked potentials (SEP; after the stimulation of both median and tibial nerves) were recorded in all subjects, and metabolic control was evaluated in terms of glycemia and glycosylated hemoglobin. In group 1, significant abnormalities were found in the latency values of VEP, median SEP, and tibial SEP compared with control subjects. Similar latency abnormalities were shown in group 2 for VEP, median SEP, and tibial SEP values and for wave I latency of BAEP. Glycosylated hemoglobin values were correlated with BAEP and SEP abnormalities in many patients in both groups. Furthermore, in group 2, glycemic values correlated with SEP abnormalities. We therefore conclude that neurophysiological abnormalities are present at different levels in IDDM and NIDDM patients only a few years after clinical diagnosis and before the appearance of overt complications, and these abnormalities seem to be correlated with metabolic control status.     

大剂量甲基维生素B12治疗多发性硬化急性期的疗效观察

目的探讨大剂量甲基维生素B12对复发缓解型多发性硬化（MS）急性期的疗效。方法72例随机分为甲泼尼龙加大剂量甲基维生素B12组36例（观察组）及甲泼尼龙组36例（对照组），比较2组的有效率、治疗前后扩充致残量表（EDSS）平均评分及神经电生理包括体感诱发电位（SEP）、脑干听觉诱发电位（BAEP）、视觉诱发电位（VEP）的变化。结果治疗7d时2组治疗前后EDSS评分均显著降低（均P〈0．001），有效率对照组为69．4％、观察组为75．0%，比较2组有效率和治疗后EDSS评分均无显著性差异（均P〉0．05）。治疗30d时观察组有效率为97．2%，明显高于对照组的77．7％（P〈O．05）；观察组EDSS评分也较对照组明显降低（P〈O．05）。诱发电位在治疗7d时2组总的改善率无差别（P〉0．05），在治疗30d时2组有显著性差异（P〈O．05），尤其在VEP、BAEP改善明显（P〈O．01）。结论甲泼尼龙加用大剂量甲基维生素B12治疗急性期多发性硬化，能提高有效率，促进神经功能的恢复，且长程使用效果可能更佳。大剂量甲基维生素B12可以作为免疫抑制治疗急性期多发性硬化的辅助治疗。     

Visual evoked potentials in differential diagnosis of multiple sclerosis and neurobehcet's disease

Behcet's disease, a multisystemic vascular inflammatory disorder of unknown origin, is relatively rare and central nervous system involvement is seen in 5% of affected individuals. This form of the disease, called as neurobehcet's disease (NB), can be misdiagnosed as multiple sclerosis (MS), a demyelinating disorder of central nervous system, so their differential diagnosis is important. In this study, to identify the parameters of electrophysiological testing that might be useful in their differential diagnosis, we performed evoked potentials (EPs) and electroneuromyography (ENMG) on patients with MS and NB, and on normal volunteers. A total of 95 persons, 55 MS patients, 20 NB patients and 20 normal volunteers between ages 31 and 55, were studied electrophysiologically. Visual evoked potential (VEP), brainstem auditory evoked potential (BAEP), posterior tibial somatosensory evoked potential (SEP) and nerve conduction and needle electromyography studies were performed on all patients and volunteers. All parameters of EPs were compared among the groups. The results of the BAEP and SEP studies did not show statistically significant difference between NB and MS. However, the VEP study indicated that the amplitude values of cortical VEP potentials (P100) in the NB and MS groups were lower than those of the normal group (p < 0.01), and that the amplitudes in the NB group were lower than for the MS group (p < 0.05). Therefore, P100 amplitude measured from peak to peak seems to be more reliable and thus should be used in the differential diagnosis of MS and NB.     

糖尿病患者诱发电位的反应与临床参量的关系

目的了解2型糖尿病(DM)患者的视觉诱发电位(VEP),脑干听觉诱发电位(BAEP)、体感诱发电位(SEP)、事件相关电位(ERP)的表现与临床参量的关系。方法用NicoletVikingTV型肌电图/诱发电位仪对30例2型DM患者(DM组)及年龄和性别与之匹配的本院医务人员正常人30例(对照组)进行VEP,BAEP,SEP,ERP检测。应用SPSS统计软件分析DM组的EP表现及其与临床参量(病程、血糖、血脂、肾功能、血管病变)的关系。结果DM组(1)VEP异常20例,BAE异常18例,MNSEP异常为20例,PTNSEP异常22例,ERP异常1例。(2)VEP的P100潜伏期(PL)明显延长,BAEP的左侧Ⅰ波PL、双侧Ⅴ波PL,波幅(Amp)和各波间期(IPL)明显异常,SEP周围电位N9至皮层电位P25/P38的PL,Amp以及ERP中N2,P3a,P3b的PL,Am都有明显异常,与对照组比较(F=5.131～45.213,t=2.695～3.472P<0.05～0.01)。(3)EP改变与各临床参量有关。结论DM患者VEP,BAEP,SEP,ERP都有不同程度异常。异常程度和病程平行。     

Recovery of spinal cord conduction after surgical decompression for cervical spondylotic myelopathy: serial somatosensory evoked potential studies

OBJECTIVE: We tested the utility of scalp-recorded median and tibial somatosensory evoked potentials (SEPs) as a measure of delineating the time course of postoperative recovery from cervical spondylotic myelopathy. DESIGN: We evaluated serial median and tibial SEP studies for 20 hands and 22 feet in 13 cervical spondylotic myelopathy patients during the first 6 mo postoperatively or longer. Serial sensory assessment of the hands and feet served to evaluate clinical correlation with the SEPs. RESULTS: The studies distinguished three recovery patterns of the SEPs based on the time course of the latencies of the N20 component for the median SEP and the P40 component for the tibial SEP. The latency started to decrease by 0.5 msec or more within 2 wk (seven hands and eight feet) or later than 2 wk (six hands and eight feet) postoperatively, or the change did not reach 0.5 msec (seven hands and six feet). In the late recovery group, the SEP improvement began as late as 10 wk postoperatively. Sensory recovery correlated with the SEP change in every group. CONCLUSIONS: An early onset of the SEP recovery predicts a favorable clinical course. The SEP may begin to improve later, and once it occurs, progressive return of function will follow.     

Visual, long-latency auditory and brainstem auditory evoked potentials in migraine: relation to pattern size, stimulus intensity, sound and light discomfort thresholds and pre-attack state

We aimed to estimate primary sensory evoked potential (EP) amplitude, amplitude-intensity functions and habituation in migraine patients compared with healthy control subjects and to investigate the possible relation to check size, sound and light discomfort thresholds, and the time to the next attack. Amplitudes of cortical visual evoked potentials (VEP, check size 8' and 33'), cortical long latency auditory evoked potential (AEP NIP1; 40, 55 and 70 dB SL tones) and brainstem auditory evoked potential (BAEP wave IV-V; 40, 55 and 65 dB SL clicks) were recorded and analysed in a blind and balanced design. The difference between the response to the first and the second half of the stimulus sequence was used as a measure of habituation. Twenty-one migraine patients (16 women and five men, mean age 39.3 years, six with aura, 15 without aura) and 22 sex- and age-matched healthy control subjects were studied (18 women and four men, mean age 39.5 years). Low sound discomfort threshold correlated significantly with low levels of BAEP wave IV-V amplitude habituation (r = -0.30, P = 0.05). VEP an AEP amplitudes, habituation, and amplitude-intensity function (ASF) slopes did not differ between groups when ANOVA main factors were considered. Control group VEP habituation was found for small check stimuli (P = 0.04), while potentiation was observed for medium sized checks (P = 0.02). The eight migraine patients who experienced headache within 24 h after the test tended to have increased BAEP wave IV-V ASF slopes (P = 0.08). This subgroup did also have a significant VEP habituation to small checks (P = 0.04). No correlation was found between different modalities. These results suggest that: (i) VEP habituation/potentiation state and brainstem activatio state may depend on the attack-interval cycle in migraine; (ii) VEP habituation/ potentiation may depend on spatial stimulus frequency; (iii) phonophobia (and possibly photophobia) may depend more on subcortical (brainstem) function than on cortical mechanisms; (iv) low cortical preactivation in migraine could not be confirmed; (v) EP habituation and ASF analysis may reflect sensory modality-specific, not generalized, central nervous system states in migraine and healthy control subjects.