多项诱发电位对职业中毒神经损害的初步研究

目的 研究多项诱发电位评估职业中毒神经损伤的临床价值。方法 对２７例职业中毒患进行运动诱发电位（ＭＥＰ）、体感诱发电位（ＳＥＰ）、肋间体感诱发电位（ＩＳＥＰ）、肌电图（ＥＭＧ）检测,同期作相关检查。结果 职业中毒男性患ＭＥＰ上下肢皮层骨髓和女性左上肢、右下肢皮层和左下肢脊髓潜伏期（ＰＬ）较正常人有显改变（Ｐ均＜０.０５）,尿中重金属浓度与诱发电位（ＥＰ）异常显相关（r＝０.２８4;Ｐ＜０.０５）。结论 诱发电位技术是评估职业中毒伴中枢及周围神经中枢损害的一种较好方法。     

慢性正己烷中毒神经损害的肌电图评价

目的 分析慢性正己烷中毒的神经肌电图表现。方法 用常规肌电图检查技术对16例慢性正己烷中毒患进行肌电图神经传导速度检测。结果 慢性正己烷中毒患电生理检查异常率为69％，感觉神经传导速度减慢为29.7%，运动神经传导速度减慢为59.4%，远端潜伏期延长为51.6%。结论 慢性正己烷中毒一损害运动神经远端为主，神经损害程度与接触时间长短有关。     

慢性二硫化碳中毒患者的神经肌电图研究

慢性二硫化碳中毒是长期接触二硫化碳引起的以神经系统改变为主的全身性疾病。我们对长期接触二硫化碳 ,有慢性二硫化碳中毒临床表现的 12例患者进行肌电图及运动神经传导速度检测 ,探讨慢性二硫化碳中毒患者进行神经肌电图检测的意义。1　资料与方法患者 12例 ,男 4例 ,女 8例 ,年龄 3 0～ 47岁 (平均 41岁 ) ,接触二硫化碳时间10～ 2 6年 (平均 2 0年 ) ,有急性中毒史者3例。 12例患者均有慢性二硫化碳中毒的临床表现如头晕、头痛 9例 ,失眠 4例 ,多梦 4例 ,记忆力减退 6例 ,肢体麻木 11例 ,心悸 9例 ,多汗 3例 ,视物模糊 4例 ,尿失禁 3例…     

急性一氧化碳中毒后迟发性脑病诱发电位研究

目的：探讨急性一氧化碳中毒迟发性脑病患者进行诱发电位检测的意义。方法：对４３例急性一氧化碳中毒后迟发性脑病患者和３２例健康成人进行短潜伏期体感诱发电位、脑干听觉诱发电位和视觉诱发电位检查。结果；ＳＥＰ、ＢＡＥＰ和ＶＥＰ的异常率分别为７５％、３２％和６０．７％，结论：多项诱发电位对该病的病情和预后判断具有重要价值。     

诱发电位对新生儿高胆红素血症亚临床神经中毒症的评估意义

目的：探讨诱发电位在新生儿高胆红素血症亚临床神经中毒症临床应用中的价值。方法：采用脑干听觉诱发电位(BAEP)，闪光视觉诱发电位(F-VEP)检测50例新生儿高胆红素血症尚未出现胆红素脑病时的神经电生理变化(其中单独检测BAEP25例，同时检测BAEP和F-VEP25例)，与同期因轻度呼吸道和肠道疾病而就诊的住院足月适龄儿的BAEP，VEP资料作为对照组。结果：高胆红素血症患儿BAEP的Ⅰ，Ⅲ，Ⅴ波的出波率及各波分化良好率均明显低于对照组，差异均有显著性意义(P&;lt;0．005～0．025)；Ⅰ，Ⅲ，Ⅴ波的潜伏期均明显延长，与对照组比较，差异有显著性意义(P均&;lt;0．001)；Ⅰ～Ⅲ，Ⅲ～Ⅴ，Ⅰ～Ⅴ波间期与对照组比较无显著延长；F-VEP主波潜伏期为(235．5&;#177;40．5)m与对照组比较，差异有显著性意义(t=5．85．P&;lt;0．001)。结论：BAEP和VEP检测在新生儿高胆红素血症中的早期诊断中有较高的敏感性，尤其是对于其听力损伤和神经系功能改变特异性较强。     

诱发电位对2型糖尿病患者视觉功能的损害

目的 通过对2型糖尿病患进行视觉诱发电位(VEP)的检测，了解患视觉中枢受损程度以及相关因素。方法 用Nicolet Viking Ⅳ型肌电图／诱发电位仪对30例2型糖尿病患(DM组)及年龄和性别与之匹配的健康正常体检30例(对照组)进行视觉诱发电位的检测应用SPSS统计软件采用t检验和直线相关分析的方法比较两组间VEP各项参数的差异，分析DM组VEP各项参数的变化与病程、血糖、血脂、肾功能之间的关系。结果 DM组20例(66．7％)有异常，与对照组比较P100潜伏期明显延长(F=14．417，P＜0．01)，波幅下降无显性差异(F=2．886，P＞0．05)。DM组VEP参数的改变与血糖、肾功随损害相关(t=3．7069，r=-0．370，x^2=4．00，P＜0．05)。结论 VEP检测随较早期的反映患视觉中枢的病变。控制血糖、保护肾功能有利于减轻患祝量中枢的损害。     

一氧化碳中毒脑电图及脑干听觉诱发电位比较

目的：了解一氧化碳中毒患者脑电图及脑干听觉诱发电位检查的变化。方法：35例一氧化碳中毒患者进行脑电图及脑干听觉诱发电位检查。结果：脑电图异常发生率为88．5％，脑干听觉诱发电位异常发生率为34．3％，两者差异有显著性。一氧化碳中毒患者电生理异常改变主要为脑电图异常而非脑干听觉诱发电位异常。结论：一氧化碳中毒患者大脑皮层病变发生率远高于脑干病变的发生率。脑干听觉诱发电位的检查结果不宜作为一氧化碳中毒程度、治疗效果及预后的客观判断指标。     

糖尿病神经系统损害的诱发电位研究

糖尿病神经系统损害是其严重并发症之一，可累及周围和中枢神经系统。其神经电生理改变常早于临床，有助于早期诊断。应用最广泛的是神经传导速度和肌电图。糖尿病的诱发电位研究历史不到二十年，虽然它在测定周围神经损害方面不如神经传导速度和肌电图精确，但既能发现糖...     

重金属中毒所致周围神经损害的电生理研究

目的：探讨处于重金属环境中的作业工人急、慢性中毒性周围神经损害的电生理改变。方法：应用常规肌电图技术对30例重金属接触者进行肌电图(EMG)、神经传导速度(NCV)检测。结果：30例患者的电生理检查均呈周围神经损害．其中急性起病18例．以轴索损害为主；慢性蓄积性中毒12例，以脱髓鞘损害为主；电生理改变下肢较上肢明显．感觉神经传导异常重于运动神经传导。结论：电生理学检查对研究重金属中毒所致的周围神经损害提供了重要的客观依据。可作为临床诊断、鉴别诊断以及了解病损程度的动态随访指标。     

脑干听觉诱发电位和体感诱发电位对昏迷患者预后的判断

目的脑干听觉诱发电位(BAEP)和体感诱发电位(SEP)与昏迷患者预后密切相关,探讨BAEP和SEP判断昏迷患者脑功能状态的可行性和准确性。方法采用丹麦Dantec公司生产Neuromatic2000型肌电图诱发电位仪。检查ICU病房中36例昏迷患者的BAEP和SEP。BAEP分析III-V波,SEP分析P15、N20、P25波。检查结果分为正常和异常。预后分为好转和死亡。结果36例患者,BAEP正常12例,异常24例。SEP正常13例,异常23例。好转13例,死亡23例。当SEP异常时,死亡率明显高于SEP正常时。而同时伴有BAEP异常时,死亡率更高。14例患者SEP检查P15、N20、P25波均消失,12例死亡,病死率为86%。5例患者BAEP检查III-V波和SEP检查P15、N20、P25波均消失,全部死亡,病死率为100%。结论BAEP和SEP的正常与否与昏迷患者的预后有密切关系(P=0.011)。SEP异常是判定的主要根据。BAEP和SEP相结合,则可以提高判断的准确性。对昏迷患者进行动态的BAEP和SEP观察可提高判断的准确性。     

Trigeminal evoked potentials in cluster headache

We sought out alterations of early trigeminal evoked potenials (TEPs) in patients suffering from episodic cluster headache, in order to evaluate a possible direct involvement of the trigeminal nerve. The study was carried out at the Centre for Pain Relief, National Institute for Cancer Research, Genoa in collaboration with the Interuniversity Centre for Pain Neurophysiology, unit of the University of Genoa. We studied 32 patients suffering from episodic cluster headache. TEPs were recorded from the scalp, after stimulation of the infraorbital nerve on both sides. The recordings were performed during the patients' bouts, but outside attacks in 24 cases. In 8 patients the recordings were performed during attacks. All 8 patients tested during an attack showed a delayed or absent W2 and W3 of the TEP, while only 3 of the 24 patients tested outside the attack had delayed W2 and W3. The alterations detected point towards a temporary impairment of conduction along the nerve fibres, approximately at the gasserian ganglion. Such a situation is consistent with a moderate compression by a swollen internal carotid artery or cavernous sinus upon the ganglion, during the attack. Received: 27 January 2000 / Accepted in revised form: 28 February 2000     

Influence of disease duration on visual evoked potentials in migraineurs

OBJECTIVE: To determine the possible influence of the duration of migraine on pattern-reversal visual evoked potentials. METHODS: An investigation was conducted in 49 patients with migraine without aura according to the International Headache Society criteria. Twenty-two of these patients had had migraine for 2 years or less (group 1), and the other 27 patients had had the disease for 10 years or more (group 2). The control group consisted of 17 healthy subjects. RESULTS: Comparison of the mean P100 latency and amplitude showed no significant difference among the groups. There was, however, a good negative correlation between age and latency (r = -0.59, P =.003) in group 1, but no such correlation was observed for group 2 or the control group. CONCLUSIONS: It was concluded that the duration of migraine has no influence on pattern-reversal visual evoked potentials and that the pathogenesis of early- and late-onset migraine may be different.     

Automated monitoring of brainstem auditory evoked potentials in the operating room

We monitored brainstem auditory evoked potentials in 112 patients undergoing retromastoid craniectomies for microvascular decompression. To provide information on latency changes as quickly as possible, we implemented a block averaging technique of data acquisition with automatic tracking of wave V latency, which is the most clinically useful information. A change in peak latency probably due to surgical manipulation was observed in 63% of the patients, and the change could be at least partially corrected by modification of surgical technique. Twenty percent ot the 89 patients who underwent preoperative and postoperative audiometric testing showed a postoperative hearing decrement. Some patients had large intraoperative increases in latency without suffering postoperative hearing deficits, and some incurred hearing deficits even though the intraoperative latency increases were relatively small. However, patients whose brainstem auditory evoked potentials were lost during surgery, even temporarily, were likely to have postoperative hearing decrements. Patients who had deficits tended to have slightly greater increases in latency than patients without deficits, but the difference in the mean increases ot the two groups was not statistically significant. Most of the deficits were small, and all resolved over time.     

Intraoperative monitoring of brainstem auditory evoked potentials following emergency evacuation of a cerebellar vascular malformation

This case report highlights the use and value of monitoring the auditory brainstem response during emergency neurosurgery. The prompt on-line changes in the auditory brainstem response after evacuation of a cerebellar arteriovenous malformation provided objective evidence of improved brainstem function, which aided in the management of this patient's disorder.     

短潜伏期体感诱发电位和闪光视觉诱发电位对脑出血患者预后的判断

目的近年来有多种诱发电位(EP)和脑外伤预后显著相关的报道,而EP和脑出血预后的关系还未见报道。本实验旨在了解发病早期短潜伏期体感诱发电位(SLSEP)、闪光视觉诱发电位(F-VEP)和脑出血近期预后的关系。方法81例脑出血患者均在发病48h内行SLSEP、F-VEP检查、Glascow昏迷评分(GCS),出院或死亡时进行Glascow预后分级(GOS)。结果SLSEP的中枢传导时间(CCT)、N20、F-VEP的N2和脑出血患者的GCS、GOS均显著相关。结论SLSEP和F-VEP是评价脑出血近期预后的有效手段。     

Non-invasive trigeminal evoked potentials: normative aging data

A mild electric shock applied to the lower lip was used to elicit reliable evoked potentials from the trigeminal nerve in 50 normal adults who ranged in age from 20 to 69 years. The waveforms were morphologically similar to those observed with invasive procedures. No substantial effects for subject age, side of stimulation, or recording electrode were obtained for any of the individual trigeminal evoked potential amplitudes or latencies. Female subjects tended to have somewhat larger amplitudes and shorter latencies than male subjects. The results suggest that non-invasive procedures produce reliable evoked potential measures of trigeminal nerve function for patients of all ages.     

糖尿病脑干听觉诱发电位分析

目的探讨脑干听觉诱发电位(BAEP)对糖尿病患者脑干功能损害的评定价值。方法对30例临床诊断为2型糖尿病的患者进行BAEP检测,并与20例正常组进行对照分析。结果糖尿病患者BAEP的异常率为63.33%,并与其病程呈正相关,但与血糖浓度无相关性。其中Ⅲ、Ⅴ波潜伏期(PL),Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ峰间期(IPL)较正常组延长,Ⅲ、Ⅴ波波幅降低,均有显著性差异(P<0.05)。结论BAEP对糖尿病脑干亚临床功能异常的诊断有重要意义。     

Coupling between visual evoked cerebral blood flow velocity responses and visual evoked potentials in migraneurs

Neurovascular coupling may be altered in migraneurs. Therefore, visual evoked potentials (VEP) and visually evoked cerebral blood flow velocity responses (VEFR) were simultaneously recorded in 30 healthy controls and 30 migraneurs interictally using a checkerboard stimulus with visual contrasts of 1%, 10% and 100%. The VEFR were measured in the posterior cerebral artery using transcranial Doppler and VEP were recorded from occipital leads. We found an increase in VEFR and VEP in both the healthy and migraneur groups (P < 0.01). VEFR were significantly higher in migraneurs (P < 0.01), while VEP did not significantly differ between the groups (P > 0.05). Regression showed a significant association between VEP and VEFR in both healthy controls (r = 0.66, P < 0.01) and migraneurs (r = 0.63, P < 0.01). The regression coefficient of migraneurs (b = 0.88, SE = 0.08) was significantly higher than that of healthy controls (b = 0.55, SE = 0.07) (P = 0.04). We conclude that neurovascular coupling is increased in migraneurs interictally.