运动神经元病的MEP、EMG、NCV与临床

目的：探讨联合应用运动诱发电位(MEP)、肌电图(EMG)和神经传导速度(NCV)对运动神经元病(MND)的诊断和鉴别诊断及分型的价值。方法：对47例MND患做MEP、EMG及NCV检查，EMG检查三个阶段以上的肌肉，其电生理变化与临床病程、分型进行比较。结果：47例MND患中，MEP异常34型，占72．3％，以中枢传导时间(CMCT)延长和波幅降低最多，占44．7％；EMG出现不同电生理变化的神经原性损害依次为运动单位时限增宽93．6％，运动单位减少89．4％，波幅增高74.5％，有纤颤、正相电位68．1％，且随病程延长纤颤、正相电位检出率逐渐降低；运动神经传导速度(MCV)测定，异常7例，占14．9％，感觉神经传导速度(SCV)测定，1条神经轻度减慢，1条波幅降低，异常率占3．3％。结论：MEP、EMG和NCV联合检查，可为MND的诊断、分型与颈椎病的鉴别诊断，提供客观依据。

RELATIONSHIP AMONG MEP, EMG, NCV AND CLINIC IN PATIEATS WITH MOTOR NEURON DISEASE

Objective:To explore the values of motion evoking potential(MEP),electromyogram (EMG)and nerve conducting velocity(NCV)in diagnosis,differential diagnosis and typing of motor neuron dis- ease(MND).Methods:We examined MEP,EMG and NCV of 47 MND patients,and compared their electro- physiological changes,clinical course and type of illness.More than three section muscles of a patient were exam- ined by EMG.Results:In 47 patients with MND 34 cases had MEP abnormity(72.3%),and 44.7% of them showed prolong of central conolucting times(CMCT)and decrease of wave amplitudes.Electrophysiological changes of neurogenic damages on EMG were prolongation of motion unit timelimited(93.6%),decrease of mo- tion unit(89.4%),increase of wave amplitudes(74.5%),fibrillation and positive potential(68.1%)and the positire rate decreased with prolongation of course of disease.In 7 patients(14.9%),motor nerve conducting ve- locity(MCV)was abnormal,sensory nerve conducting velocity(SCV)slowed slightly in a nerve and wave am- plitude decreased in another one.Conclusions:Using MEP,EMG and NCV jointly could provide objective evi- dence of diagnosis and type of MND and differential diagnosis of MND with cervical spondylopathy.