特发性面神经麻痹的神经电生理研究

目的 探讨特发性面神经麻痹患电生理变化与预后的关系。方法 以48例特发性面神经麻痹患进行患侧与健侧面神经传导速度及肌电图检查。结果 神经传导速度检测是面神经运动潜伏期延长，M波波幅降低，与则相比差异显（P＜0．05）；肌电图检测显示串侧面肌运动单位电位时限延长，多相波增多，募集电位减弱，并有自发电位出现。结论 特发性面神经麻痹患神经电生理变化与预后有关，患健侧M波波幅比值＞50％面瘫恢复较好，＜30％面瘫恢复较差。     

特发性面神经麻痹的神经电图特点

采用肌电图/诱发电位仪对28例特发性面神经麻痹患者进行病侧和健侧的神经电图检查,并对结果进行对比分析。结果显示患侧与健侧比面神经运动传导潜伏期延长、波幅降低。提示神经电图有助于特发性面神经麻痹的诊断,能指导治疗及预后评价。     

神经-肌电图检测对周围性面神经麻痹的临床意义

目的:评价神经-肌电图在周围性面神经麻痹损伤程度、预后评估中的应用价值。方法:选取100例确诊为周围性面神经麻痹患者,于病程第5～7天行神经-肌电图检查,记录患侧面神经各支诱发电位的传导速度、波幅以及所支配肌肉的肌电图情况,并与自身健侧作对照。结果:周围性面神经麻痹患者健、患侧面神经传导速度、波幅比较,差异有统计学意义(P<0.05)。结论:神经-肌电图检查对周围性面神经麻痹的损伤程度、预后评估有重要价值。     

中西医结合治疗面神经麻痹30例

本文采用神经电生理手段,观察评价牵正散治疗面神经麻痹的疗效。现将结果报告如下。１临床资料入选对象均为单纯的面神经麻痹、周围性面瘫的患者,共３０例,男１８例,女１２例,年龄１９～７２岁,平均年龄４２．６岁,病程为１～１２０ｄ。面神经传导检查提示患侧面神经传导速度潜伏时较健侧延长越多,患侧的诱发肌电动作电位Ｍ波波幅较健侧变小越悬殊,病变受累越严重,反之则病变越轻［１］。随机分为牵正散治疗组和西药对照组,简称治疗组和对照组,每组各１５例。在西药疗法的基础上加用中医治面瘫的传统方剂牵正散,观察记录健患两侧眼轮匝肌神…     

神经肌电图对周围性面瘫的评估作用

为探讨周围性面瘫患者进行神经电图与肌电图检查的意义,对３０例正常人和７８例周围性面瘫患者进行神经电图和肌电图检查对比。结果：患侧面神经运动传导潜伏期延长,波幅降低,与健侧相比差异有极显著性,同时干扰型减弱。提示ＥＮＧ与ＥＭＧ均对周围性面瘫能定性与定量诊断,指导治疗和评估预后。     

面神经麻痹56例神经肌电图分析

目的 探讨神经电生理检查对面神经麻痹患者的诊断价值.方法 对56例面神经麻痹患者分别于病后1周内及2周后行神经肌电图检测,并于3个月后复查.结果 与健侧比较,EMG无动作电位出现,NCV潜伏期延长,波幅降低明显者为面神经严重损害,恢复差;其次为轻,中度损害者,预后较好.结论 神经肌电图的检测为临床评估面神经的损害程度及判断预后提供有力的诊断依据.     

周围性面神经瘫痪30例神经肌电图观察

应用肌电图仪对30例周围性面神经瘫痪患者做健、患侧肌电图、运动传导潜伏期(Lat)和诱发电位波幅(Amp)的检测,结果30例患侧肌电图均有失神经电位,部分性损害27例,严重损害2例,完全性损害1例。Amp均明显衰减,与健侧对比差异有显著性意义(P<0.01)。表明通过神经肌电图检测可以较全面客观诊断面神经损害的程度,对判断其预后有一定的价值。     

瞬目反射和面神经电图在Bell′s麻痹中的应用

目的探讨Bell’s麻痹患者行瞬目反射(blinkreflex,BR)、面神经电图(electroneurogram,ENG)检测的意义。方法36例Bell′s麻痹患者在发病1周内行BR和ENG测定。结果患侧R1、R2及R2′缺如者23例,其余13例患侧较健侧R1、R2及R2′波潜伏期延长,异常率100%;患侧面神经运动传导潜伏期延长、波幅降低,与健侧比较差异有显著性(P<0.05),早期异常率为63.9%。结论BR测定是诊断Bell’s麻痹的敏感指标,同时结合ENG可全面、客观地评价面神经损害的程度和预后。     

瞬目反射和面神经电图在Bell’s麻痹中的应用

目的探讨Bell’s麻痹患者行瞬目反射（blink reflex，BR）、面神经电图（electroneurogram，ENG）检测的意义。方法36例Bell’s麻痹患者在发病1周内行BR和ENG测定。结果患侧R1、R2及R2’缺如者23例，其余13例患侧较健侧R1、R2及R2’波潜伏期延长，异常率100％；患侧面神经运动传导潜伏期延长、波幅降低，与健侧比较差异有显著性（P＜0．05），早期异常率为63．9％。结论BR测定是诊断Bell’s麻痹的敏感指标，同时结合ENG可全面、客观地评价面神经损害的程度和预后。     

面神经麻痹肌电图及面神经传导速度的观察

0引言面神经麻痹肌电图、面神经运动潜伏期和M波波幅的变化及其临床意义是目前诊断面神经麻痹最好的、客观的定量检查手段。1材料和方法1.1材料单侧周围性面神经麻痹患者25例,男17例,平均年龄50(12～75)岁;女8例,平均年龄53(29～80)岁。病程3～40d。1.2方法采用日本光电公司生产的肌电图———诱发电位仪,室温24℃,以同芯圆针电极检测双侧口轮匝肌、患侧额肌观察插入电位、肌松驰时的自发电位、轻用力时的运动单位电位的时限、波形、波幅以及最大用力时的募集情况。面神经传导速度检查:接地线置于同侧手臂部,记录针电极置于口轮匝肌口角处,…     

电生理检测对贝耳麻痹患者的预后评估

INTRODUCTIONBellpalsyisoneofthemostcommondiseasesinneurologicalde－partment．HowtopredicttheprognosisofBellpalsyiswhatdoctorsandpatientsareconcernedabout．MATERIALSANDMETHODSMaterialsClinicalmaterialswerecollectedfromFebruary１９９６toDecember２０００．４２caseswereselectedfrom１０６casesofBellpalsywhosemanifestationsandelectrophysiologicaltestwerefollowedupcontinuously．Patientssex：２２menand２０women；Agerang：１８－７４yearsold，averageage：３８yearsold；Thefirsttestingtimew…     

Electrophysiologic evaluation of the facial nerve in Bell's palsy. A review

Facial nerve paralysis is the most common mononeuropathy and idiopathic facial paralysis (Bell's palsy) the most common seventh nerve disease electromyographers may be asked to evaluate. The electrophysiologic method of choice to assess the facial nerve is side-to-side evoked amplitude comparison with the affected side expressed as a percentage of the nonaffected side. This examination should be performed on days 3, 5, 7, 9, 11 and 13 after onset of paralysis. If the percentage of surviving axons falls below 10% within the first 14 days, an incomplete recovery is suggested. Electromyography may assist in prognosticating a functional return, determining neural conduction across the site of injury and following reinervation in the recovery period. The persistence or early return of an absent R1 component of the blink reflex may qualitatively suggest a satisfactory functional outcome in facial paralysis. Supramaximally exciting the facial nerve at the stylomastoid foramen and comparing the clinical response on the affected and nonaffected side, maximum stimulation test, can also predict eventual seventh nerve return. Observing a minimal twitch, utilizing the nerve excitability test or measuring the facial nerve latency have yielded poor correlations with functional return and are of limited usefulness in the prognostication of acute facial palsies. Trigeminal somatosensory evoked potentials can be employed to evaluate the status of the trigeminal nerve as approximately 50% of patients with Bell's palsy also have lesions involving the fifth nerve. Side-to-side amplitude comparison and electromyography are the two most valuable electrophysiologic methods of assessing facial nerve functioning.     

肌内效贴配合局部理疗治疗Bell麻痹的疗效观察

目的:观察肌内效贴疗法联合物理因子治疗Bell麻痹的疗效。方法:Bell麻痹患者72例随机分为观察组及对照组各36例,2组均采用超短波及超声波等物理因子治疗,观察组在此基础上加用肌内效贴扎术治疗。治疗前后运用简易面神经功能评分法、瞬目反射及面神经传导进行疗效评价。结果:治疗1个月后,2组简易面神经功能评分均较治疗前明显提高(P0.01),且观察组更高于对照组(P0.01);观察组平均治愈时间较对照组明显缩短(P0.01);2组患侧瞬目反射R1,R2潜伏时均较治疗前明显缩短(P0.05),且观察组更优于对照组(P0.05);2组患侧面神经传导速度均较治疗前明显提高(P0.01),且观察组更优于对照组(P0.05)。结论 :肌内效贴疗法联合物理因子治疗Bell麻痹可增加疗效,加速面神经恢复,缩短治愈时间,适宜临床推广应用。     

Usefulness of BFB/EMG in facial palsy rehabilitation

Objective. To analyze and to compare the recovery and the development of synkinesis in patients with idiopathic facial palsy (Bell's palsy) following treatment with two methods of rehabilitation, kinesitherapy (KT) and biofeedback/EMG (BFB/EMG).

Study design. Retrospective cases - series review.

Methods. Seventy-four patients with Bell' palsy were clinically evaluated within 1 month from onset of palsy and at 12 months after palsy (House scale and synkinesis evaluation). Electromyography (EMG) and Electroneurography (ENG) were performed about 4 weeks after palsy to better evaluate functional abnormalities due to facial nerve lesion. The patients followed two different protocols for rehabilitation: the first 32 patients were treated with therapeutic exercises performed by therapists (KT group), the latter 42 patients were treated using BFB/EMG methods (BFB group) with inhibition of synkinetic movement as the primary goal.

Results. KT and BFB patients were evaluated for clinical and neurophysiological characteristics before rehabilitative treatment. BFB patients showed better clinical recovery and minor synkinesis than KT patients.

Conclusions. BFB/EMG seems to be more useful than KT in Bell's palsy treatment. This could be due to the fact that BFB/EMG gives more accurate information than KT on muscle activation with better modulation in voluntary recruitment of motor unit.     

Usefulness of BFB/EMG in facial palsy rehabilitation

Objective.?To analyze and to compare the recovery and the development of synkinesis in patients with idiopathic facial palsy (Bell's palsy) following treatment with two methods of rehabilitation, kinesitherapy (KT) and biofeedback/EMG (BFB/EMG).

Study design.?Retrospective cases?–?series review.

Methods.?Seventy-four patients with Bell’ palsy were clinically evaluated within 1 month from onset of palsy and at 12 months after palsy (House scale and synkinesis evaluation). Electromyography (EMG) and Electroneurography (ENG) were performed about 4 weeks after palsy to better evaluate functional abnormalities due to facial nerve lesion. The patients followed two different protocols for rehabilitation: the first 32 patients were treated with therapeutic exercises performed by therapists (KT group), the latter 42 patients were treated using BFB/EMG methods (BFB group) with inhibition of synkinetic movement as the primary goal.

Results.?KT and BFB patients were evaluated for clinical and neurophysiological characteristics before rehabilitative treatment. BFB patients showed better clinical recovery and minor synkinesis than KT patients.

Conclusions.?BFB/EMG seems to be more useful than KT in Bell's palsy treatment. This could be due to the fact that BFB/EMG gives more accurate information than KT on muscle activation with better modulation in voluntary recruitment of motor unit.     

腰椎间盘突出症的电生理检查分析

为探讨电生理检查对腰椎间盘突出症的诊断意义,对１２３例（病例组）腰椎间盘突出症患者进行肌电图、运动神经传导速度、Ｆ波传导速度和Ｈ反射检测,并与正常人组比较和健患侧对比。结果：病例组肌电图和Ｈ反射的异常率分别为８７．８％和９０．０％,Ｆ波传导速度减慢显著。提示：综合电生理检查能早期定位神经根病损的范围,判断程度和预后,有助于腰椎间盘突出症的诊断。     

神经电图-肌电图检测对多灶性运动神经病的评估作用

目的:探讨神经电图(ENG)和肌电图(EMG)检查对多灶性运动神经病(multifocalmotorneuropathy,MMN)的诊断价值及康复干预的评估作用。方法:对16例诊断为MMN的患者进行电生理检查,受试者为MMN组16例和正常组16例,分别进行运动神经传导速度(MCV)和感觉神经传导速度(SCV)检查,记录刺激引出的复合肌肉动作电位(compoundmus-cleactionpotentials,CMAP)的波幅、波宽、面积、位相、时限进行对比分析,判定是否有运动神经传导阻滞(conductionblock,CB)或暂时性离散(temporaldispersion,TD)。并有选择性地进行常规肌电图检查。结果:16例患者中均见有一根以上运动神经或至少一根运动神经的一个以上部位出现CB或TD。其中13例双上肢正中神经,尺神经出现CB,3例首发为正中神经尺神经的远端出现CB,随病情进展出现下肢腓深神经CB。仅有两例感觉神经传导速度稍有减慢,波幅略有降低。16例患者神经受累区域以下所支配肌肉肌电图检查见有运动神经源性受损改变。结论:MMN病是一种以远端神经受累为主的不对称性周围神经病,神经电生理检查对诊断和鉴别诊断MMN起重要作用,CB是MMN特征性表现。     

自体静脉套吻合端套管内注入脑细胞生长肽对面神经损伤功能恢复的作用

背景面神经损伤后功能恢复需要较长时间,如何加速面神经的功能恢复是该领域正在研究的课题.目的比较面神经损伤修复的不同方法,探讨自体静脉套接吻合口及脑细胞生长肽在临床上修复面神经损伤的效果.设计以诊断为依据的病例对照研究.地点和对象中国医科大学附属第一医院1999-01/2001-12收治44例面神经损伤患者和1999-01以前收治面神经损伤患者30例.干预对44例创伤后和腮腺区恶性肿瘤切除造成的面神经损伤患者,在手术显微镜下行神经断端对位吻合,将自体静脉管套入吻合口并在管套内注入脑细胞生长肽.对30例面神经损伤患者采用传统神经端吻合法修复,术后不同时间观察面部表情肌功能恢复及肌电图的动态变化.主要观察指标观察面部表情肌功能恢复的时间,检测面神经传导速度的动态变化.结果30例创伤性面神经损伤患者,功能恢复最快9周,最迟13周,平均(11.1±1.1)周,与传统方法(25.8±1.8)周比较有显著性差异(t=34.875,P＜0.01);14例肿瘤切除面神经立即修复的患者,功能恢复最快13周,最迟15周,平均(13.8±0.8)周,与传统方法(34.8±2.9)周比较有显著性差异(t=26.336,P＜0.01).肌电图检测面神经传导速度的恢复呈递增趋势,表情肌功能恢复时两种方法传导速度比较无显著性差异(P＞0.05).结论自体静脉管套入吻合口并注入脑细胞生长肽的方法均比传统方法效果显著,是一种临床效果比较突出的面神经损伤修复方法.     

腕尺管综合征肌电图检测分析

目的探讨腕尺管综合征的肌电图表现。方法对13例腕尺管综合征患者行肌电图检测,包括尺神经运动潜伏期、运动波幅、尺神经小指感觉传导速度、感觉波幅等,与其健侧对照比较,评估肌电图表现差异。结果腕尺管综合征患者其患侧肌电图与健侧比较,尺神经运动潜伏期延长(P<0.01),运动波幅缩小(P<0.01),尺神经小指感觉传导速度减慢(P<0.01)、感觉波幅缩小(P<0.01),小指展肌、第Ⅰ骨间肌肌电图也出现静息状态及重收缩状态的改变。结论腕尺管综合征患者存在肌电图的多项改变,早期检测对于其诊断及其治疗具有重要意义。