59例听神经瘤患者脑干听觉诱发电位分析

目的 分析听神经瘤(acoustic neuroma,AN)患者的脑干听觉诱发电位的变化特征及健侧耳峰间期改变.方法 对59例听神经瘤(AN)患者进行脑干听觉诱发电位(BAEP)检测,测定Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)、峰间期(IPL),双耳PL、IPL之间差值(ILD)等数值.结合MRI、CT影象学资料进行分析,并与36例健康者对照.结果 AN组与正常对照组BAEP各波PL、IPL测值比较差异有极显著性(P＜0.01).AN患侧BAEP异常率98.3%(58/59);主要表现:①Ⅰ、Ⅲ、Ⅴ波缺失;②Ⅲ、Ⅴ波PL延长;③Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长.AN患者健侧BAEP的异常率69.5%(41/59),主要表现:①Ⅴ波PL延长;②Ⅲ～Ⅴ及Ⅰ～Ⅴ波IPL延长;③Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值＞1.肿瘤直径＞2cm,BAEP的异常率有显著提高.不同大小肿瘤组间健侧BAEP测值比较:健侧Ⅴ波PL差异有显著性(P＜0.05),Ⅲ～Ⅴ及Ⅰ～ⅤIPL差异有极显著性(P＜0.01).结论 BAEP对AN诊断具有重要意义,它为病变提供了定位诊断依据,尤其健侧Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值异常,是脑干受压的敏感指标.     

脑干听觉诱发电位在后循环脑梗死中的临床应用价值研究

目的 通过分析急性和慢性后循环脑梗死患者脑干听觉诱发电位变化特点,探讨脑干听觉诱发电 位（brainstem auditory evoked potential,BAEP）在后循环脑梗死早期识别和诊断方面的临床应用价值。 方法 选择2018年8月-2019年3月在上海第六人民医院神经内科就诊的后循环脑梗死患者为研究 对象,分为急性脑梗死组和慢性脑梗死组,同时设立健康对照组。比较3组BAEP的Ⅰ、Ⅲ、Ⅴ各波峰 潜伏期（peak latency,PL）,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波和Ⅰ～Ⅴ波峰间潜伏期（interpeak latency,IPL）,Ⅲ～Ⅴ波 /Ⅰ～Ⅲ波I PL的比值等指标的特点。 结果 研究共入组急性脑梗死组患者36例,慢性脑梗死组32例,健康对照组32例。急性脑梗死组 Ⅲ波、Ⅴ波PL较慢性脑梗死组（P＜0.001、P =0.005）和对照组（均为P＜0.001）均延长;慢性脑梗死组 Ⅴ波PL较对照组延长（P＜0.001）。急性脑梗死组Ⅰ～Ⅲ波、Ⅰ～Ⅴ波I PL较慢性脑梗死组延长（P＜0.001、 P =0.029）;急性脑梗死组Ⅰ～Ⅲ波（P＜0.001）、Ⅲ～Ⅴ波（P =0.006）和Ⅰ～Ⅴ波（P＜0.001）IPL较对照 组延长;慢性脑梗死组Ⅲ～Ⅴ波I PL（P =0.003）较对照组延长。慢性脑梗死组Ⅲ～Ⅴ/Ⅰ～Ⅲ波IPL比值 异常者有9例（25.0%）,急性脑梗死组2例（6.3%）,两组差异有统计学意义（P =0.001）。 结论 ①BAEP检查能灵敏地检测出急性和慢性后循环脑梗死患者的听觉感觉通路的电生理异常。 ②急性脑梗死患者BAEP的Ⅲ波和Ⅴ波PL、Ⅰ～Ⅲ波和Ⅰ～Ⅴ波IPL均显著延长,以Ⅲ波PL、Ⅰ～Ⅲ波IPL延 长为主;慢性脑梗死患者BAEP以Ⅴ波PL、Ⅲ～Ⅴ波IPL的延长为主。     

后循环梗死患者的BAEP、BR、TCR变化的临床意义

目的探讨后循环梗死（PCI）患者脑干听觉诱发电位（BAEP）、瞬目反射（BR）、三叉神经-颈反射（TCR）三种电生理变化。方法选择50例经头颅MRI检查证实为PCI患者,分别行BAEP、BR、TCR检查。BAEP观察其波形,Ⅰ、Ⅲ、Ⅴ峰波潜伏期（PL）、峰波间期（IPL）、波幅（Amp）;BR观察R1、R2、R2’波平均潜伏期、波幅;TCR观察各成分潜伏期、波幅、A值。结果 50例中,BAEP检查异常45例,异常率90%,异常主要表现为Ⅲ、Ⅴ波PL延长,Ⅲ～ⅤIPL大于Ⅰ～ⅢIPL,Ⅰ/Ⅴ波幅大于1。BR检查异常42例,异常率84%,异常主要表现为R1、R2、R2’波PL延长,R2、R2’波幅下降。TCR检查仅5例异常,异常率10%,头颅MRI显示多为延髓梗死。结论 BAEP、BR两种电生理检查方法能较好反映PCI患者脑干功能异常;TCR电生理检查方法异常率低,但对延髓梗死检查有特异性。三者联合应用可提供重要参考价值。     

脑干听觉诱发电位在老年人椎基底动脉供血不足的诊断价值

目的 探讨脑干听觉诱发电位(BAEP)测定对诊断老年人椎基底动脉供血不足(VBI)的临床价值.方法 选择符合可临床确诊为VBI的60例老年患者为病例组,在眩晕症状发作期进行BAEP测定.并选择60例老年体检者为对照组.结果 病例组60例中有26例(43.3%)BAEP测定异常,BAEP测定异常病例中内耳型异常有10例(38.5%),8例表现为波I PL延长,2例表现为波I PL的ILD>0.4ms.脑干型异常16例(61.5%),10例表现为Ⅰ～Ⅲ IPL延长,2例为Ⅲ一Ⅴ的IPL延长和2例为Ⅰ-Ⅴ IPL的ILD>0.4ms等.对照组BAEP检查无异常.结论 BAEP检查为无创和客观测定,对老年人VBI的损伤部位(脑干或听神经通路)及损伤的程度都具有诊断意义,可作为老年人内耳型和脑干型病变定位的客观诊断指标.     

合并糖尿病对后循环短暂性脑缺血发作患者脑干听觉诱发电位的影响

目的使用诱发电位仪检测后循环短暂性脑缺血发作（transient ischemic attack,TIA）患者脑干听觉诱发电位（Brainstem auditory evoked potential,BAEP）的变化,探讨合并糖尿病（DM）的后循环TIA患者受损部位的特点。方法入组后循环TIA病例共58例,其中合并糖尿病组20例,无糖尿病组38例,使用诱发电位仪分别检测其BAEP的变化。结果2组后循环TIA患者的Ⅲ波、Ⅴ波波峰潜伏期（Peaklatency,PL）,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波峰间潜伏期（Interpeak latency,IPL）均较正常值延长,其中合并DM组Ⅲ波PL、Ⅰ～Ⅲ波IPL与无DM组的Ⅲ波PL、Ⅰ～Ⅲ波IPL比较有显著性差异（P〈0.05）,而无DM组的Ⅲ-Ⅴ波IPL与合并DM组的Ⅲ～Ⅴ波IPL比较有显著性差异（P〈0.05）。结论合并DM的后循环TIA患者听神经及脑桥下段较无DM的TIA患者更容易受到缺血性损伤。     

帕金森病脑干听觉诱发电位变化30例报告

目的 探讨脑干听觉诱发电位(BAEP)对帕金森病的诊断价值.方法 对30例帕金森病人进行脑干听觉诱发电位(BAEP)检查.结果 30例帕金森病人双耳听阈增高,Ⅰ～Ⅲ波潜期延长者13例,Ⅲ～Ⅴ波潜期延长者17例,Ⅰ～Ⅴ波潜期延长者9例,Ⅰ～Ⅴ波潜期不清楚5例.提示不同程度的听觉通路及脑干的损害.结论 脑干听觉诱发电位对帕金森病的诊治有临床应用价值,值得推广.     

后循环梗死患者的BAEP、BR、TSEP检测

目的:探讨后循环脑梗死(PCI)患者脑干听觉诱发电位(BAEP)、瞬目反射(BR)、三叉神经诱发电位(TSEP)三种电生理变化.方法:选择60例经头颅MRI检查证实为PCI患者(病例组),分别于人院一周之内行BAEP、BR、TSEP检查,观察BAEP波形及Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)、峰间期(IPL),计算BR的R1、R2、R2′波平均PL、波幅及TSEP各成分PL,并与40例健康体检者作对照.结果:病例组60例中BAEP异常35例(58%),异常主要表现为Ⅰ、Ⅴ波的PL、Ⅰ-Ⅴ波的IPL延长和Ⅰ/Ⅴ波幅比＞1.BR异常33例(55%),异常主要表现为R2波的PL延长,R2、R2′波幅下降.TSEP检查病例组与对照组PL比较未见明显差异.结论:BAEP、BR两种电生理检查方法能够较好地检测出PCI患者神经功能异常,联合应用BAEP及BR能够为PCI患者的神经功能的判断提供重要参考.     

椎基动脉系统脑卒中脑干听觉诱发电位

本文报道8例椎基动脉系统脑卒中的脑干听觉诱发电位(BAEP)检查结果,联系临床和CT探讨其诊断价值。 方法 BAEP测试方法和正常数值参阅作者以前有关报道,确定BAEP异常主要根据波峰缺失和峰间期(IPL)延长,IPL包括Ⅰ—Ⅲ、Ⅲ-Ⅴ和Ⅰ—Ⅴ,凡>X+2.5SD者属轻度,>3SD为明显,Ⅴ/Ⅰ波幅比值<0.5时为Ⅴ波低波幅。 结果 一、BAEP异常表现 附表列出8例病人临床诊断,CT和BAEP资     

脑创伤后长期意识障碍患者脑干听觉诱发电位表现与预后清醒的关系

目的 探讨重型创伤性颅脑损伤(TBI)后长期意识障碍患者脑干听觉诱发电位(BAEP)表现与预后清醒的关系.方法 分析63例重型TBI后意识障碍超过2周患者的BAEP表现,主要为BAEP中Ⅰ、Ⅲ、Ⅴ波各波峰潜伏期(PL),Ⅰ～Ⅲ、Ⅲ～Ⅴ波峰间潜伏期(IPL)及Ⅰ波与Ⅴ波波幅比.预后以TBI后6个月患者是否清醒为标准,分为清醒组与未清醒组,组间运用两独立样本t检验以筛选出有意义的指标.结果 本组患者清醒率为34.9%(22/63),BAEP指标异常率为66.7%(42/63).双侧Ⅰ、Ⅲ、Ⅴ波PL,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波IPL及Ⅰ/Ⅴ波幅比均正常的21例中有16例清醒(清醒率为76.2%),双侧Ⅴ波PL异常的8例及双侧Ⅲ～Ⅴ波IPL异常的7例均未清醒,单侧Ⅴ波消失的2例未清醒.清醒组与未清醒组间比较发现双侧差异均有统计学意义的指标为Ⅴ波PL及Ⅲ～Ⅴ波IPL.结论 BAEP的Ⅴ波PL及Ⅲ～Ⅴ波IPL变化可客观、准确地反映脑损伤的程度及预测患者的预后.

Abstract：

Objective To explore the correlation between brainstem auditory evoked potential (BAEP) findings and outcome in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BAEP findings were recorded and analyzed in 63 patients suffering from severe TBI with duration of disturbance of unconsciousness for more than 2 weeks. The peak latency (PL) of wave Ⅰ, Ⅲ and Ⅴ, the interpeak latency (IPL) of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ and the amplitude ratio of wave Ⅰ and Ⅴ were analyzed. Conscious or unconscious at 6 months after the injury was considered as the outcome criterion,and based on these, the patients were divided into conscious and unconscious groups; the significant indicators were chosen in the 2 groups using independent-sample t test. Results The probabilities of awakening in these patients were 34.9% (22/63) with abnormal index of BAEP indicators reaching 66.7%. Sixteen patients were sober at last in 21 patients with normal PL of wave Ⅰ, Ⅲ and Ⅴ, IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ, and amplitude ratio of wave Ⅰ and Ⅴ in bilateral side (the probabilities of awakening were 76.2%); 8 patients having abnormal PL of wave Ⅴ in bilateral side and 7 having abnormal IPL of wave Ⅲ-Ⅴ in bilateral side were unconscious; 2 patients having disappeared wave Ⅴ in unilateral side were unconscious. PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side were significantly different between the conscious group and the unconscious group. (P＜0.05). Conclusion BAEP findings (PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side) can objectively and accurately demonstrate the cerebral dysfunction and predict the outcome of the patients.     

大鼠脑桥、中脑电损伤后脑干听觉诱发电位的敏感性研究

目的 探讨大鼠脑桥、中脑电损伤后脑干听觉诱发电位(BAEP)的敏感指标.方法 SD大鼠80只,分别于左侧脑桥面丘和中脑上下丘之间深部给予电损伤,按照电流刺激量的不同各分为小剂量组(1 mA)、中剂量组(3 mA)、高剂量组(6 mA)、对照组(0 mA),每组10只,记录和比较各组电损伤前后的BAEP各指标的变化.每组取2只行病理学检查.结果 电损伤后,脑组织均有不同程度的神经元坏死等改变,损伤程度随电流量加大而增加.脑桥小剂量组BAEP的V波的PL、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,中剂量组的Ⅲ、V波的PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,高剂量组的Ⅲ、Ⅴ波的PL、Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波IPL延长,伴Ⅲ、Ⅴ波的波幅下降;中脑中剂量组、高剂量组V波PL延长,Ⅰ～Ⅴ、Ⅲ～Ⅴ波IPL延长,损伤前后的差值与对照组比较,有统计学意义.结论 (1)BAEP的Ⅴ波PL可能为反映脑桥和中脑损伤的敏感指标;(2)BAEP反映中脑损伤不如脑桥敏感.

Abstract：

Objective To explore the sensitive indexes of brainstem auditory evoked potentials(BAEP)in rats exposed to electric injury in the pons and the midbrains.Methods The pones and midbrains of 80 rats were electric injured beneath the left facial colliculus and quadrigeminal bodies.In the pone group or the midbrain group,the animals were further divided into 4 groups:controls(0 mA),low (1 mA),middle(3 mA)and high electric current(6 mA)respectively,according to the amount of electrical stimulation.The indexes of BAEP were recorded and analyzed before and after injury.Results It was shown that electric injury resulted in neuronal necrosis,the extent of which tended to be designated as much more severe according to the amount of electrical stimulation.In the pone groups,the peak lantency(PL)of waves Ⅴ and the interpeak lantency(IPL)of waves Ⅰ～Ⅴ,Ⅲ～Ⅴ were prolonged at low electric current. However,the PL of waves Ⅲ,Ⅴ and the IPL of waves Ⅰ～Ⅲ,Ⅲ～Ⅴ,Ⅰ～Ⅴ were prolonged at middle and high electric current,and the amplitudes of waves V were decreased at high electric current significantly compared with the controls.In the midbrain groups,the PL of waves Vand the IPL of waves Ⅲ～Ⅴ,Ⅰ～Ⅴ at middle and high electric current were prolonged significantly compared with the controls.Conclusions The peak lantency of the waves V may be the most sensitive indexes of BAEP as to the pons and midbrains injured,but the changes of BAEP is less sensitive in midbrain than in pons.     

The changes of brainstem auditory evoked potentials (BAEP) after vertebrobasilar artery ischemia in rabbits

Brainstem auditory evoked potentials (BAEPs) have been used as a valuable neurophysiologic index of neuronal dysfunction in the level of the brainstem. BAEPs are also useful in subdividing evoked potentials into normal, slight, or pronounced in patients with vertebrobasilar insufficiency. We investigated the changes of BAEP after vertebrobasilar artery ischemia in rabbits and its significance in clinical work. A brainstem ischemic model was made by unilateral extracranial occlusion of vertebral artery to monitor BAEPs at 0, 10, 20, 30, 40, 50, and 60 min after occlusion. We found that peak latencies (PL) of I, III, and most notably V were gradually extended. In addition, we observed a significant (P < 0.05) delay of interpeak latencies (IPL) of waves I–III, III–V, and I–V after occlusion. This delay became more significant in IPL I–V 60 min after occlusion. Our results also demonstrate that the amplitude of I and V had no obvious change (P < 0.05). In the rabbit with bilateral extracranial occlusion of vertebral artery, BAEP waveforms disappeared 10 min after occlusion. Our results showed that vertebrobasilar insufficiency caused brainstem ischemia, which induced BAEP abnormity. Taken together, our findings suggest that BAEP has important significance for the clinical diagnosis of vertebrobasilar insufficiency. Therefore, early detection of neuronal change after transient cerebral ischemia is important in initiating treatment within the therapeutic window.     

前庭阵发症脑干听觉诱发电位的特点

目的探讨前庭阵发症(VP)脑干听觉诱发电位(BAEP)的特点。方法对51例VP患者的BAEP结果进行回顾性分析。结果 BAEP异常者40例,异常率为78.4%。与Ⅰ-Ⅲ波峰间期正常的患者相比,Ⅰ-Ⅲ波峰间期延长的患者男性比例高(χ2=4.763,P=0.029),病程显著延长(t=2.469,P=0.021),而平均年龄差异无统计学意义。与Ⅲ-Ⅴ波峰间期正常的患者比较,Ⅲ-Ⅴ波峰间期延长的患者男性比例、平均病程、平均年龄差异均无统计学意义。与Ⅰ-Ⅲ波峰间期耳间差正常的患者比较,Ⅰ-Ⅲ波峰间期耳间差延长的患者病程相对较长(P=0.055),男性有增多趋势(P=0.058),但差异无统计学意义。结论 VP患者BAEP异常以Ⅰ-Ⅲ波峰间期延长为主,且以男性更多见。病程越长,蜗神经越易受累。     

Brain-stem auditory evoked potentials in different age groups

Brain-stem auditory potential (BAEP) latencies were measured from individuals with normal or nearly normal hearing. Different age groups were studied separately. Males have 0.1-0.2 msec longer latencies of waves III and V and longer I-V IPLs than females in all age groups. The latencies of waves I, III and V increase 0.1-0.2 msec with increasing age, but the I-V IPL was the same in all age groups. The recognizability was very good for waves I, III and V and fairly good for waves II and IV. There was no interaural time difference.     

听神经瘤患者BAEP特征和术中面听神经保留情况分析

目的 分析听神经瘤(AN)患者脑干听觉诱发电位(BAEP)特征和显微外科手术中面、听神经保留情况.方法 安徽医科大学附属省立医院神经外科自2006年5月至2009年5月共采用肿瘤切除术治疗76例AN患者,术前术中均进行BAEP检查,分析患者术前、术中BAEP异常情况及AN直径大小与和术后面、听神经保留情况的关系.结果 AN患者术前患侧BAEP异常76例(76/76,100%),健侧BAEP异常63例(63/76,82.9%),两侧比较差异有统计学意义(P<0.05);术中健侧BAEP异常70例(70/76,92.1%),与术前健侧BAEP异常率比较差异有统计学意义(P<0.05);术中健侧BAEP异常与面、听神经的保留分别呈正相关关系(r=0.912,P=0.000;r=0.613,P=0.000);而AN直径与面、听神经的保留分别呈负相关关系(r=-0.869,P=0.000;r=-0.738,P=0.000).结论 术前BAEP检测对AN病变提供诊断依据,术中进行BAEP监测可提高面听神经的保留率,且AN直径越大,面、听神经越难保留.     

Evidence for atypical auditory brainstem responses in young children with suspected autism spectrum disorders

Aim The aim of this study was to characterize the auditory brainstem responses (ABRs) of young children with suspected autism spectrum disorders (ASDs) and compare them with the ABRs of children with language delay and with clinical norms. Method The ABRs of 26 children with suspected ASDs (21 males, five females; mean age 32.5mo) and an age‐ and sex‐matched group of 26 children with language delay (22 males, four females) were analysed. All children had normal hearing. The absolute latencies of waves I, III, and V, and interpeak latencies (IPLs) I to III, I to V, and III to V of the group with ASDs and the group with language delay were compared. Data from both groups were further compared with clinical norms. Results All absolute latencies and IPLs were significantly prolonged in the group with suspected ASDs compared with the group with language delay, excluding IPL III–V (all p‐values <0.05) and with clinical norms (all p‐values <0.001; IPL III–V, p<0.05). Significant prolongation of absolute and IPLs was also evident in the group with language delay compared with clinical norms, excluding IPL III to V (all p‐values <0.001). The prevalence of abnormal findings in two or more absolute latencies was found to be significantly higher in the group with ASDs (50%) than in the group with language delay (8%; p=0.002). Interpretation The results provide first‐time evidence for a neurodevelopmental brainstem abnormality that is already apparent in young children with suspected ASD and language delay. The overlap in ABR findings supports the assertion that an auditory processing deficit may be at the core of these two disorders.