同步记录反映脊髓背与腹侧病变的诱发电位的研究

目的研究反映脊髓腹侧损伤的诱发电位,探讨其临床应用价值。方法表面电极刺激胫神经,针电极同步记录Ｃｚ Ｆｐｚ（ＳＥＰ）,枕点－Ｆｐｚ（ＣＥＰ）之诱发电位,检测健康人群及脊髓、小脑病变患者。对比研究同步记录的ＳＥＰ、ＣＥＰ,以观察两者在脊髓背、腹侧病变和小脑病变时差别及ＣＥＰ各波出现异常的方式。结果ＳＥＰ与ＣＥＰ是两个相互独立的诱发电位。ＳＥＰ反映脊髓背侧病变,而脊髓腹侧病变,小脑病变可影响ＣＥＰ。ＣＥＰ异常的方式主要表现为Ｎ３０、Ｐ４０波幅降低,潜伏期延长以及Ｎ３０宽大、畸形,失去正常的尖锐外形。结论ＣＥＰ和ＳＥＰ的联合应用,在脊髓病变的检测及诊断中有着重要的价值。

Study on evoked potentials of the lesion ventrally and dorsally located on spinal cord by the simultaneous recording

Objective To study the sensory evoked potential which could show the lesion on the spinal cord ventrally, and evaluate its application in clinical practice.Methods By stimulating the posterior tibial nerve, the evoked potentials were recorded on the Cz Fpz,and occiput Fpz simultaneously. Health controls and patients of spinal and cerebellar disease have been investigated. The difference of evoked potentials between Cz Fpz and occiput Fpz were compared,abnormal patterns of the potential from occiput Fpz were studied in patients with lesion located ventrally and dorsally on spinal cord or cerebellum.Results The evoked potentials recorded from Cz Fpz and Occiput Fpz were independent. The evoked potential of Cz Fpz could reflect lesions located dorsally on spinal cord.The lesion located ventrally in the spinal cord and cerebellum could affect the evoked potential recorded from occiput.The abnormal forms of occiput Fpz potential were absent,or decreased amplitude,prolonged lantency in N30 and P40.N30 sometime could show abnormal shape without sharp peak. Conclusion The combination of potentials recorded from Cz Fpz and Occiput Fpz has an important value in detection and diagnosis of spinal diseases.