重症肌无力患者视、听、体感诱发电位研究

目的：研究重症肌无力(MG)患者视觉诱发电位(VEP)、脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)的变化及其与中枢神经系统(CNS)损害的关系。方法：对22例临床及重复神经电刺激(RNS)确诊的MG患者行VEP、BAEP检测，其中的18例还进行了SEP检测。结果：22例MG患者中VEP异常15例(68．2％)、BAEP异常8例(36．4％)。SEP检查18例均异常，其中上肢SEP异常8例(44．4％)，下肢SEP异常10例(55．6％)。结论：MG患者的VEP、BAEP、SEP均有不同程度异常，表明MG患者可伴有CNS损害，而VEP、BAEP、SEP可作为早期发现MG患者CNS改变的有效检测手段。     

多发性硬化患者的视觉、听觉和体感诱发电位的诊断价值

目的:探讨视觉诱发电位(VEP)、听觉诱发电位(BAEP)、体感诱发电位(SEP)对多发性硬化(MS)的诊断价值。方法:对22例临床诊断为MS的患者进行VEP、BAEP、SEP检测,并与正常对照组进行比较分析。结果:22例MS患者中VEP异常15例(68.2%),BAEP异常9例(40.9%),SEP异常12例(54.5%),异常中VEP有53.3%、BAEP有44.4%、SEP有58.3%的患者,临床有相应症状。结论:VEP、BAEP、SEP的检测有助于MS诊断以及亚临床病灶的发现。     

诱发电位对痴呆和非痴呆型帕金森病与宾斯旺格病的比较研究

目的 :探讨帕金森病 (PD)与宾斯旺格病 (BD)患者的中枢神经通路和认知功能状态。方法 :对无痴呆的PD 2 8例 (PD组 ) ,伴痴呆的PD 2 2例 (DPD组 )及BD组 18例进行①体感诱发电位 (SEP)、②视觉诱发电位 (VEP)、③脑干听觉诱发电位 (BAEP)和④事件相关电位 (ERP)检查。结果 :①SEP :PD组中 5例 (18% )异常 ,DPD组中 8例 (36 % )异常 ,BD组中 11例 (6 1% )异常 ;②VEP :PD组仅 1例 (4% )异常 ,DPD组中 4例 (18% )异常 ,BD组 3例 (17% )异常 ,经统计学处理 ,潜伏期与左右眼差值均无显著差异 ;③BAEP :PD组中 4例 (14% )异常 ,DPD组中 5例异常 (2 3% )异常 ,BD组 4例 (2 2 % )异常 ;④ERP :PD组中 5例异常 (18% ) ,DPD组 9例异常 (41% ) ,BD组 11例异常 (6 1% )。结论 :SEP和ERP阳性率最高 ,其阳性率的顺序为BD >DPD >PD ,提示三组病例的中枢神经系统功能的损害有明显区别。     

P300等诱发电位对亚临床肝性脑病早期诊断的意义

目的:观察事件相关电位P_(300)、体感诱发电位、视觉诱发电位和脑干听觉诱发电位在亚临床肝性脑病诊断中的意义。方法:50例亚临床肝性脑病患者进行了心理测验,并做了头颅CT和视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位检查,30例正常人做为对照组。结果:亚临床肝性脑病的心理测验,韦氏法智力低下率为76％,视觉诱发电位异常率为13％,脑干听觉诱发电位异常率为20％,体感诱发电位异常率为40％,事件相关电位异常率为71％,正常对照组四种诱发电位的正常率是100％。头颅CT结果与亚临床肝性脑病无关。结论:视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位在亚临床肝性脑病中是异常的。事件相关电位更为敏感,对亚临床肝性脑病的早期诊断有重要意义。     

Visual and brainstem auditory evoked potentials in hereditary motor-sensory neuropathy

Visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were recorded in 57 children and adults with hereditary motor-sensory neuropathy (HMSN); 37 of them were diagnosed as type I (demyelinating) and 20 as type II (axonal). None of the patients presented central nervous system involvement. The results were compared with VEP and BAEP records of 12 adults with Guillain-Barré syndrome (GBS) and 40 healthy controls. Above 30% of all patients with HMSN I showed delayed latency of the VEP. These abnormalities were less expressed in HMSN II. Abnormal BAEP were observed in almost 50% of patients with HMSN I and HMSN II with nearly the same frequency in both types but more pronounced in HMSN I. The most common feature was prolongation of the I-III interpeak latency (JPL). The VEP and BAEP changes could be present simultaneously in the same patient (mainly in HMSN I) or separately. More often the abnormalities were observed in the adult patients. Normal VEP and BAEP values were present in all patients with GBS. The results strongly suggest the subclinical optical and auditory pathways involvement in HMSN patients.     

多种诱发电位和MRI检查在多发性硬化诊断中的价值

目的：探讨诱发电位和磁共振成像（MRI）检查在多发性硬化（MS）诊断中的价值。方法：收集65例MS患者的临床资料、磁刺激运动诱发电位（MEP）、脑干听觉诱发电位（BAEP）、视觉诱发电位（VEP）、体感诱发电位（SEP）以及MRI结果,比较不同检测方法对其临床诊断的价值。结果：MS患者的磁刺激MEP、BAEP、VEP、SEP以及MRI的异常检出率分别为78％（51／65）、51％（33／05）、80％（52／65）、71％（46／65）和85％（55／65）。4项诱发电位检查总异常检出率为88％（57／65）,与MRI检查结果比较差异无统计学意义（P〉0．05）。各种诱发电位和MRI检查均能发现临床下病灶：6例患者经MRI检查发现病灶但无相应临床症状;8例患者有临床症状而MRI检查未见相应病灶,但诱发电位检查可见异常。结论：MRI和各种诱发电位检查具有相互补充作用,结合临床合理选择使用此两种检查有助于提高MS诊断的敏感性。     

帕金森病患者VEP、BAEP及SEP的测定

目的：研究帕金森病（PD）患者视觉诱发电位（VEP）、脑干听觉诱发电位（BAEP）及体感诱发电位（SEP）的变化并推测其发生机制。方法：选择2008年1月至2013年1月在昆明医学院第一附属医院神经内科门诊及住院的80例PD患者作为PD组,50例健康对照者作为对照组。应用神经电生理检查仪分别对PD患者和健康者进行VEP、BAEP和SEP检测,并进行比较。结果：PD组VEP的P100潜伏期（115．1±10．6）ms较健康对照组（103．2±9．0）ms明显延长（P〈0．01）,P100波幅（6．25±3．02）弘V较健康对照组（7．70±2．62）pV增高（P〈0．05）;PD组BAEP的I、Ⅱ、Ⅲ波的潜伏期和Ⅲ-V及I—V峰间期较对照组明显延长（P〈0．05）;SEP各波潜伏期及波幅两组比较差异无显著意义。结论：PD患者的VEP和BAEP均有不同程度的改变,提示PD患者可能伴有脑干听觉传导通路与视觉俜导诵略的桶害．     

慢性肝病肝硬化的脑干诱发电位的初步研究

在我们嘉兴地区,由于曾是血吸虫病流行区,因此对血吸虫病肝纤维化及混合性肝硬化发病率高,为了解肝硬化患者与脑干诱发电位的关系,我们于1995年1月～1996年12月对100例肝硬化肝功能失代偿患者,其中还包含有32例由于肝硬化门静脉高压并发上消化道大出血的患者进行了脑干听觉诱发电位(BAEP),视觉诱发电位(VEP),体感诱发电位(SEP)进行测试,其结果BAEP阳性率为50％,VEP阳性率为18％,SEP阳性率为12％,本文检测对象年龄从21岁～82岁,平均年龄为51.5岁,所以还必须对年龄因素来进行分析,以便客观和确切的来探讨肝硬化与脑干诱发电位之间的关系。     

亚临床肝性脑病患者多种形式诱发电位联合检测的临床意义

目的:探讨事件相关电位(P300),脑干听觉诱发电位(BAEP),体感诱发电位(SEP),视觉诱发电位(VEP)对亚临床肝性脑病(SHE)的临床诊断价值.方法:根据临床分级,对36例临床诊断为亚临床肝性脑病(SHE)的患者进行P300、BAEP、SEP、VEP检测分析.结果:36例SHE患者中P300异常者26例(72%),BAEP异常者23例(64%),SEP异常者17例(47%),VEP异常者9例(25%).结论:P300、BAEP、SEP、VEP的检测有助于亚临床肝性脑病(SHE)的早期诊断.     

视觉、脑干听觉诱发电位对多发性硬化的诊断价值

目的 :探讨视觉诱发电位 (VEP)、听觉诱发电位 (BAEP)对多发性硬化 (MS)的诊断价值。方法 :对 30例临床诊断为MS的患者进行VEP、BAEP检测 ,并与正常对照组进行比较分析。结果 :MS患者VEP和BAEP的异常率分别为 73%和 6 0 %。异常中VEP有 6 8% ,BAEP有 78%的患者 ,临床有相应的症状 ;VEP 32 % ,BAEP 2 2 %的患者临床无相应症状。 5例MS患者在临床缓解期复查VEP、BAEP ,1例VEP、BAEP恢复正常 ,4例仍异常。结论 :VEP、BAEP检测对MS的诊断具有重要意义。     

The usefulness of the brainstem auditory evoked potential in the early diagnosis of cranial nerve neuropathy associated with diabetes mellitus

BACKGROUND: An evaluation of the extent and mechanism of damage of the central nervous system in diabetes mellitus is of high value in current neurological research. Electrophysiological abnormalities are frequently present is completely asymatomatic diabetes mellitus (DM) patients. Limited data is available in the use of brainstem auditory evoked potential (BAEP) in DM. AIM: Is to evaluate the efficacy of BAEP as a method useful in the diagnosis of subclinical damage of the central nervous system in DM. MATERIAL AND METHOD: 67 diabetes and 32 healthy controls - age and sex matched - were chosen. The diabetes were of type I and II and more than or less than 10 years duration. The BAEP was elicited by using auditory stimulus by using Dantec Evomatic 4000 evoked potential machine. The latency of component response recored as waves I, III and V, interpeak latency (IPLs) I - III, I - V, III - V and amplitude of waves V. RESULTS: The difference was highly significant in the increased latency of waves I, III and V, interpeak latency (IPLs) I - III, I - V, III - V and amplitude of waves V of each type of diabetes as compared to control. Comparison of the type and duration of diabetes between each other showed no significant difference. CONCLUSION: BAEP recording can represent an objective, clinically useful and non invasive procedure to stress the early impairment both of the auditory nerve and of brainstem function.     

脑白质疏松症患者的诱发电位研究

对２４例经颅脑ＣＴ证实的脑白质疏松症患者进行脑干听觉诱发电位（ＢＡＥＰ）和短潜伏期体感觉诱发电位（ＳＥＰ）检查，结果ＢＥＡＰ总异常率７９％，ＳＥＰ总异常率８３％，两种诱发电位均以时间参数的异常率明显比波幅度参数的异常率高。结论：在脑白质疏松症的临床早期，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。     

橄榄脑桥小脑萎缩2O例的神经电生理检查

目的：探讨橄榄脑桥小脑萎缩（OPCA）患者各项神经电生理检查结果的特点并比较其对OPCA诊断的敏感性。方法：对20例OPCA患者进行多种电生理检查,并结合其临床表现分析电生理变化。结果：各项神经电生理检查中,除了脑干听觉诱发电位（BAEP）结果与患者的年龄、病程以及病情严重程度有关外,其他如体感诱发电位（SEP）和瞬目反射（BR）均与之无关,且这两项检查的异常检出率均低于BAEP（P〈0．05）。结论：OPCA患者可表现为中枢神经系统广泛损害,而BAEP的敏感性较其他检查的敏感性高也提示OPCA患者在脑干听觉通路中枢段出现功能障碍较其他结构出现障碍的几率大。     

Evozierte Potentiale in der Diagnostik von Polyneuropathien

Polyneuropathies are characterized by a widespread damage of the peripheral nervous system. Evoked potentials (EP) are of low sensitivity for axonal damage, but demyelinisation ist well documented. In particular, somatosensible evoked potentials (SEP) provide additional informations in proximally accentuated and slight, but diffuse demyelinisations. Multilevel measurement is necessary to allocate conduction slowing to peripheral (or central) nervous system. In advanced cases, SEP measurements may provide nerve conduction velocity values despite absent peripheral sensory potentials. In addition, SEP measurements are well suitable for monitoring polyneuropathies over time. The best evidence is available for immunogenic and diabetic polyneuropthies. In polyneuropathies of other origin mainly case series with small case numbers exist.     

CNS involvement in chronic inflammatory demyelinating polyneuropathy: an electrophysiological and MRI study

Eight consecutive patients with chronic inflammatory demyelinating polyneuropathy (CIDP) were investigated by visual evoked potential (VEP), brainstem auditory evoked response (BAER) and magnetic resonance imaging (MRI) to assess central nervous system (CNS) involvement. VEPs were abnormal in 6 patients and BAERs in 2. MRI showed changes suggestive of CNS demyelination in 2 cases. Our findings suggest the existence of a combined central and peripheral demyelinating syndrome and emphasize the possibility of a common pathogenetic mechanism for both.     

Auditory neuropathy in streptozotocin-induced diabetic mouse

An investigation of the mechanism of damage to the peripheral nervous system and central nervous system in diabetes mellitus (DM) is highly important in current neurological research. Auditory neuropathy is a hearing disorder in which the auditory brainstem evoked potential is absent or severely abnormal. This study investigated auditory neuropathy caused by streptozotocin in mouse model. In order to assess diabetic auditory neuropathy, we evaluated auditory brainstem response (ABR) for the evaluation of sensorineural function in peripheral auditory nerve. Auditory middle latency response (AMLR) was employed to assess the middle response in the midbrain. STZ groups significantly increased the absolute latencies IV and the interpeak latencies I-III and I-IV of ABR compared with STZ 0 group. Pa latency of AMLR also significantly increased in proportion to STZ dosage. Taken together, our results demonstrate that STZ-induced DM may impair the auditory pathway from peripheral auditory nerve to midbrain in the mouse model. We suggest that the STZ-induced diabetic mouse model may be useful for the evaluation of auditory pathway impairment by using ABR and AMLR tests.     

Visual evoked potential & brainstem auditory evoked potentials in acute attack & after the attack of migraine

PURPOSE: To study the effect on visual evoked potential (VEP) and brainstem auditory evoked potential (BAEP) at time of acute attack and after 7 days of the attack of migraine. MATERIAL AND METHODS: We studied BAEP and pattern reversal VEP in 25 patients during acute attack and after 7 days of the attack. The diagnosis of migraine was established according to criteria given by international headache society (IHS). Peak and interpeak latencies (IPL's) of BAEP and P100 latency of VEP were the main criteria to judge abnormalities. RESULTS: There were prolonged peak and interpeak latencies in BAEP and prolonged peak latency (P100) in VEP at the time of acute attack of migraine. The data of these abnormal recording were highly significant. After 7 days when the attack was over, we recorded the BAEP and VEP again. The observation obtained at this time was comparable to normal values. CONCLUSIONS: From the observation of this study we can safely conclude that in acute attacks of migraine there may be some pathological changes in different areas of brain and brainstem, producing changes in evoked potential which are statistically highly significant. However, these changes are reversible, as the values of BAEP & VEP on 7th day after the attack were comparable to those observed in normal healthy control.     

Visual and auditory evoked potentials in migraine

We recorded visual (VEP) and brainstem auditory (BAEP) evoked potentials in 50 patients with clinically diagnosed common migraine attended by visual obscuration or sensory symptoms but no neurologic deficit. VEPs were recorded from Oz, 01, and 02 referenced to Fz, with replication of 200 repetitions of 1.88 per second checkerboard stimuli subtending a 56 minute retinal arc. Analysis time was 250 ms., and filter band pass was 1-250 Hz. BAEPs utilized rarefaction stimulation at 70 dB SL, with 150-3,000 Hz filter band pass and 10 ms. analysis time. Two thousand averages were recorded and replicated from Cz-A1 and Cz-A2. VEP N1, P1 and N2 latencies were longer in migraine patients than in controls, and VEP amplitudes were minimally greater. No significant differences were found between patients and controls, however. BAEP I-V and III-V interpeak latencies were significantly prolonged in migraine patients, and the degree of prolongation was greater on the left. Neither VEPs nor BAEPs exceeded clinical norms in migraine patients. VEPs and BAEPs are likely to add little to the clinical assessment of headache patients. BAEP differences may indicate dysfunction of brainstem centers, possibly related to endorphin or serotonin neurotransmission, and possibly related to the pathogenesis of migraine. The left sided asymmetry has been described previously and is of uncertain significance, but may also support a central mechanism for migraine.     

Multievoked potentials in type I diabetic patients: one year follow-up study.

A neurophysiological (SEP, VEP) follow-up study was carried out in 30 diabetic patients with type I diabetes mellitus of ten or more years duration. This in order to investigate whether one year of improved glucoregulation may influence the progression of central damage. In our series, patients showed a significant decrement of HbA1C levels (p < 0.05) in the one-year follow-up. In the same period the frequency of SEP and VEP abnormalities varied from 10/30 (33%) to 16/30 (53%) and from 8/30 (26%) to 5/30 (16%) respectively. This finding would suggest that prevailing glycaemic control would be a major determinant for the outcome of VEP measurements. SEP alterations, in contrast, tend to progress in a 12 months period despite a considerable improvement in glycaemic control. However, by dividing patients in two groups according mean one year HbA1C less than 8% and more than 8%, the latter group only showed a significant increasing of absolute latencies of each median and tibial SEP components. Our results suggest that VEP abnormalities are still reversible in diabetic patients with improved metabolic control. The acquired abnormalities of somatosensory pathways persist longer, but a strict glycaemic control may influence and retard the progression of central conduction involvement.     

基底动脉尖综合征患者的听觉及体感诱发电位的研究

目的：探讨听觉诱发电位（BAEP）和体感诱发电位（SEP）对评价基底动脉尖综合征（TOBS）的治疗效果及预后的价值。方法：回顾分析22例诊断符合TOBS患者的BAEP及SEP的检查结果，并与患者出院时的神经功能缺损程度作对比性研究。结果：TOBS患者SEP的潜伏期、BAEP潜伏期及峰间潜伏期均有不同程度的延迟，且反映其动态变化与患者的神经功能缺损程度及临床转归密切相关。结论：BAEP及SEP对TOBS的治疗指导及预后判断有较高的价值。