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1.
目的 探讨脑干听觉诱发电位(BAEP)对儿童结核性脑膜炎(TBM)预后的评估价值.方法 对2007年1月-2010年 8月本科初治的48例TBM患儿进行BAEP检测.男28例,女20例;年龄1~13岁.测量Ⅰ、Ⅲ 、Ⅴ波潜伏期和波幅,Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波峰间期.BAEP结果分级采用Hall分级标准.TBM患儿入院当天行改良Glasgow评分.出院后随访3个月,比较不同 BAEP 级别TBM患儿的预后不良率;比较BAEP和Glasgow评分对TBM患儿预后评估的价值.结果 BAEP 1级18例中预后不良 1例,2级22例中预后不良6例,3级6例中预后不良4例,4级2例均预后不良;BAEP中1级、2级、3级和4级的预后不良率分别为5.6%、27.3%、66.7%和100.0%,差异有统计学意义(P<0.01).BAEP分级与不良预后发生率呈正相关(r=0.56,P<0.05).BAEP 对TBM患儿的预后评估:真阴性38例,假阴性2例,真阳性7例,假阳性1例;Glasgow评分对TBM患儿的预后评估:真阴性31例,假阴性5例,真阳性4例,假阳性8例;BAEP对TBM患儿预后评估的敏感性、特异性、准确率和错误率分别为77.8%、97.4%、93.6%和6.3%;Glasgow评分对TBM患儿预后评估的敏感性、特异性、准确率和错误率分别为44.4%、79.5%、72.9%和 27.1%,2种评估方法比较差异有统计学意义(Pa<0.05,0.01).结论 BAEP可反映TBM患儿的脑损伤程度,有助于评估预后;BAEP对TBM患儿的预后评估价值优于Glasgow评分.  相似文献   

2.
目的 探讨脑干听觉诱发电位(BAEP)对重症和危重症手足口病患儿脑损伤的评价作用。方法 以2010年8月至2011年12月在广州市妇女儿童医疗中心住院治疗的重症和危重症手足口病患儿作为重症组和危重症组,于入院时和病程2周时行BAEP检查,以同期住院的无神经系统受损表现的手足口病患儿为对照组,于入院时行BAEP检查。比较3组BAEP各项指标间的差异。采用脑干反应阈值及Hall分级法比较治疗前后BAEP的变化情况。结果 重症组121例,危重症组102例,对照组200例进入分析。①对照组未见BAEP异常病例,重症组34例(28.1%)BAEP异常,危重症组49例(48.0%)BAEP异常,差异有统计学意义(P<0.05)。BAEP Ⅲ波PL延长、Ⅲ或Ⅴ波波幅低平或分化不良的发生率危重症组显著高于重症组(P<0.05)。②重症组和危重症组脑干反应阈值在治疗后较治疗前均显著降低(P<0.05)。治疗前危重症组脑干反应阈值显著高于重症组(P<0.05),治疗后两组差异不显著。重症组和危重症组治疗后BAEP 1级所占比例均较治疗前显著增加,2和3级比例均有下降。结论 重症和危重症手足口病患儿均存在脑干功能损伤,以脑干反应阈值升高、Ⅲ波PL延长、Ⅲ波和Ⅴ波波幅低平或分化不良为主。Hall分级法和脑干反应阈值可动态评估BAEP变化,推测病情可能的演变。  相似文献   

3.
目的探讨晚婴型异染性脑白质营养不良(MLD)患儿脑诱发电位改变特点及应用价值.方法对6例MLD患儿进行了脑干听觉诱发电位(BAEP)和正中神经体感诱发电位(MNSEP)测试,并与头颅CT结果比较.结果6例MLD患儿BAEP和MNSEP结果均异常,BAEP异常主要包括Ⅰ波潜伏期延长、Ⅰ~Ⅲ和Ⅰ~Ⅴ峰间期延长;MNSEP异常主要有N9波低平、波潜伏期延长或波形消失,N9~N13和N13~N20峰间期延长,而N20波幅改变不明显.结果还表明,诱发电位的异常早于头颅CT结果.结论诱发电位较早地反映患儿神经传导功能障碍,可以作为无创性早期诊断手段.  相似文献   

4.
注意缺陷障碍患儿体感诱发电位与事件相关诱发电位研究   总被引:3,自引:4,他引:3  
目的 探讨注意缺陷障碍 (ADHD)患儿体感诱发电位 (SEP)和事件相关诱发电位 (ERP)改变的特征及其对脑功能损害程度的诊断价值。方法 实验组为 6 1例ADHD患儿 ,病理对照组 2 7例智力低下 (MR)患儿 ,正常对照组为 2 3例健康儿童。对 3组同时行SEP、ERP检测 ,观察各组成波潜伏期和形态改变。结果 AD HD组MR与正常对照组比较 ,SEP的N2、P2、N3等潜伏期延长 ,ADHD右侧改变较左侧明显 ,MR儿童改变较ADHD更明显 ,且左侧较右侧明显 ,ERPP30 0潜伏期ADHD、MR儿童均较正常对照组延长 ,统计学处理均有显著性差异 (P <0 .0 5 )。结论 ADHD与MR均有脑功能损害 ,ADHD右侧重于左侧 ,MR以左脑为主 ,二者均有认知功能障碍 ;MR脑功能损害更严重。SEP、ERP可作为临床诊断ADHD并判断其脑功能及疗效的客观指标之一  相似文献   

5.
新生儿高胆红素血症脑干听觉诱发电位的临床意义   总被引:3,自引:0,他引:3  
通过脑干听觉诱发电位(BAEP)的检测,研究血清胆红素水平对新生儿听力的影响。对240例(480耳)高胆红素血症患儿进行了BAEP检测,并以240例正常新生儿作为对照组,随访监测异常患儿。高胆患儿中BAEP异常16l例(253耳),总异常耳数率52.7%。同时发现高胆红素血症程度越重,BAEP异常改变越严重。随访114例BAEP异常患儿,14例仍有中、重度异常,其中脑瘫2例。研究提示,BAEP是简便易行、无创性、客观性好的检测方法,能及早发现听力异常并进行干预。  相似文献   

6.
早产儿视觉诱发电位检查及其临床意义   总被引:2,自引:0,他引:2  
目的 探讨视诱发电位在早产儿的应用及临床意义。方法 早产儿共 76例 ,其中实验组 2 1例 ,对照组 5 5例。两组患儿均在生后 7~ 14d行视觉诱发电位 (VEP)检查 ,实验组还同时进行了脑干听觉诱发电位(BAEP)检查。同时检测了 2 6例足月儿 ,与对照组早产儿进行比较。对异常者在生后 3个月、6个月进行了随访。结果 早产儿与足月新生儿一样 ,VEP波形及各波潜伏期已基本稳定 ,重复性好 ,尤以P1波检出率为10 0 %。孕周与P1波潜伏期两者密切相关。实验组患儿同时进行VEP和BAEP检查 ,两种检查方法无显著差异。实验组患儿P1潜伏期均明显长于相应孕周对照组 (P <0 0 5 ) ;其中实验组 15例早产儿异常 ,VEP主要改变既有单、双侧主波缺失、又有主波潜伏期延长。对VEP异常者随访发现 ,实验组 15例VEP异常患儿中 9例 (9/12 ,3例失访 )及对照组 4例异常者均在生后 3个月恢复正常。结论 VEP在早产儿的检查客观、准确。其波形可作为早产儿脑发育成熟的指标。主波缺失 (包括单、双侧 )被认为是严重异常 ,提示预后较差。  相似文献   

7.
新生儿高胆红素血症脑干听觉诱发电位的临床意义   总被引:2,自引:0,他引:2  
通过脑干听觉诱发电位(BAEP)的检测,研究血清胆红素水平对新生儿听力的影响.对240例(4800耳)高胆红素血症患儿进行了BAEP检测,并以240例正常新生儿作为对照组,随访监测异常患儿.高胆患儿中BAEP异常161例(253耳),总异常耳数率52.7%.同时发现高胆红素血症程度越重,BAEP异常改变越严重.随访114例BAEP异常患儿,14例仍有中、重度异常,其中脑瘫2例.研究提示,BAEP是简便易行、无创性、客观性好的检测方法,能及早发现听力异常并进行干预.  相似文献   

8.
脑瘫患儿脑干听觉诱发电位   总被引:1,自引:0,他引:1  
采用日本产MEB-5304K诱发电位测定仪对101例6个月~14岁脑瘫患儿测定其脑干听觉诱发电位(DAEPL)。结果:在80dBnHL,20Hz刺激时BAEP异常率为45.54%。随刺激强度减小及刺激重复率增加,BAEP阳性率提高。主要为外周性听路损害,而两侧性损害占65.22%。患儿组BAEP波Ⅰ、Ⅲ、VPL长于对照组,Ⅰ、Ⅴ波振幅降低,以Ⅴ波振幅降低较恒定。重型组VPL、Ⅲ-Ⅴ、Ⅰ-Ⅴ IPL及BTT均延长,Ⅴ波振幅降低;手足徐动型组VPL、Ⅲ-Ⅴ  相似文献   

9.
脑性瘫痪患儿67例粗大运动功能分级与体感诱发电位对比   总被引:3,自引:0,他引:3  
目的 探讨脑性瘫痪(脑瘫)患儿体感诱发电位(SEP)的临床特点及其与分型之间的关系.方法 选取2003年2月-2006年12月分别在本院和南海妇儿医院小儿脑瘫康复中心诊治的67例脑瘫患儿.67例患儿均行SEP检查,同时采用脑瘫粗大运动功能分级系统(GMFCS)对脑瘫患儿的临床特点进行评价.采用SPSS 10.0软件进行分析.结果 本组SEP总异常率为82.1%,GMFCSⅠ级、Ⅱ级、Ⅲ级、Ⅳ级、Ⅴ级异常率分别为61.5%(8/13例)、73.9%(17/23例)、94.1%(16/17例)、100%(9/9例)、100%(5/5例);各组SEP主波缺失率分别为0、0、11.8%、56.0%、60.0%.轻、中度脑瘫患儿SEP异常以皮层电位潜伏期延长、波幅降低和侧间差增大为主;重度脑瘫患儿SEP异常以皮层电位波形缺失或分化不清为主.轻、中度脑瘫与重度脑瘫患儿SEP异常率比较具有显著性差异(x2=32.09 P<0.01).本组脑瘫以痉挛型为主,共50例(占74.6%).痉挛型偏瘫9例,其中功能障碍轻度5例、中度4例,SEP异常者9例(占100%),均表现为皮层电位侧间差增大,偏瘫对侧皮层电位异常,下肢较上肢损害明显.痉挛型四肢瘫11例,其中功能障碍中度5例、重度6例,SEP异常者10例(占90.9%),上、下肢SEP异常均同时存在.痉挛型双瘫30例,其中功能障碍轻度8例、中度21例、重度1例,SEP异常者26例(占86.7%),下肢异常较上肢明显且阳性率高.混合型脑瘫7例,其中功能障碍中度4例、重度3例,SEP异常者6例(占85.7%);不随意运动型脑瘫10例,其中功能障碍中度6例,重度4例,SEP异常者4例(占40.0%).结论 SEP对脑瘫患儿的功能障碍程度和分型具有重要的判断价值.  相似文献   

10.
目的  通过对新生儿高胆红素血症患儿进行脑干听觉诱发电位 (BAEP)检测 ,评估高胆红素血症在未发生核黄疸时对脑损害及听力的影响。 方法  对新生儿高胆红素血症患儿入院后进行脑干听觉诱发电位的测定。 结果   49例高胆红素血症患儿中异常BAEP发生率为 3 7%( 18/ 49例 ) ,表现为各波潜伏期 (PL)及波间潜伏期 (IPL)的延长和听阈值的增高 ,听阈值随胆红素浓度的增高而增高 ,经治疗后黄疸消退 ,脑干听觉诱发电位大部分恢复正常。 结论  高胆红素血症对新生儿可造成听力损害 ,BAEP是检测高胆红素血症患儿听力筛查的重要手段之一  相似文献   

11.
BACKGROUND: To determine the effects of malnutrition on the developing brain with brainstem auditory evoked potentials (BAEP) and flash visual evoked potentials (fVEP). METHODS: The BAEP and fVEP of 11 kwashiorkor (8 +/- 1.56 months) and 10 marasmus (7.9 +/- 1.27 months) patients and 10 healthy control subjects (7.65 +/- 0.82 months) were recorded and the measurements were compared with each other in relation with plasma total protein and albumin levels. RESULTS: There were no differences between the mean latencies of the waves I, II, III and IV and mean interpeak latencies (IPL) of the waves I-III of the BAEP and the wave IV (N2) of the fVEP between the three groups. Mean latency of the wave V and mean IPL of the waves I-V and the waves III-V were significantly different between the three groups. The kwashiorkor group had significantly longer mean latency of the wave V than the marasmus group on the right ear and the control group on the both of the ears. The kwashiorkor group had significantly longer mean IPL of the waves I-V than the marasmus group on the right ear and than the control group on the left ear. The kwashiorkor group had also significantly longer mean IPL of the waves III-V than the control group on the left. CONCLUSIONS: The BAEP and fVEP are non-invasive electrophysiologic methods reflecting the integrity or disruption of the central neurologic pathways. The present results confirm the disruption of the central nervous system with the BAEP in children with protein-energy malnutrition, especially in kwashiorkor patients.  相似文献   

12.
We evaluated the predictive value of somatosensory evoked potentials (SEP) in a series of children with severe traumatic brain injury (TBI). The prospective clinical investigation was performed in a Level I paediatric trauma centre. We included 26 consecutive comatose paediatric patients aged from 1 month to 17 years (median age 11 years) following severe TBI (initial Glasgow Coma Score (GCS) 8 or below). Besides SEP recordings, the intracranial pressure and the results of an initial cranial CT scan were filed. The Glasgow Outcome Scale (GOS) was used to assess outcome at discharge. Thirteen children had normal SEP measurements, three patients had abnormal SEP recordings and a cortical response was bilaterally absent in ten children. Out of 26 children, 10 died whereas two remained in a persistent vegetative state. Only one child suffered from significant neurological deficits (GOS 3) at discharge. Seven patients survived with a GOS of 4 and six children survived without neurological impairment (GOS 5). Normal SEP indicated a favourable outcome in most children but did not rule out the occurrence of death, while absence of SEP was related to unfavourable outcome in all cases. Conclusion: Measurement of somatosensory evoked potentials provides valuable data for determining the prognosis at early coma stages. Our data show that an unfavourable outcome can be predicted with higher precision than a favourable outcome.  相似文献   

13.
脑干听觉诱发电位在儿科临床应用的价值   总被引:7,自引:0,他引:7  
本文对1240例患儿BAEP资料进行了分析,正常518例,异常722例。其中新生儿,乳幼儿486例;轻-重度异常占74.5%双侧极重度异常占25.5%。BAEP异常最高的疾患为听力障碍,听力障碍危险因素,语言障碍,脑干肿瘤智力障碍和脑性瘫痪。  相似文献   

14.
Aim: To investigate the sensory functions of the peripheral to central pathways in infants with Down syndrome (DS) by sensory evoked potentials. Methods: Fifty-five infants, 30 DS infants and 25 controls, were examined by multimodal evoked potentials, including brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP) and short-latency somatosensory evoked potentials (SSEP). Results: No obvious difference was found in the peak latencies between the two groups for BAEP. Nine children with DS showed abnormal BAEP; six had hearing loss and three had prolonged wave I latencies. For VEP, the peak latencies of P2 and N2 were significantly longer and the amplitudes were smaller in the DS group than in the control group. Of the 30 infants with DS, five had significantly prolonged P2 latencies and two had lower amplitudes. In SSEP, the mean latencies of N20 and the interpeak latencies of N13-N20 of the infants with DS showed apparent prolongation compared to the controls. Seven of 30 (23.3%) DS patients had prolonged N20 latencies.

Conclusion: Our results indicate that various sensory deficits occur in patients with DS during the first year of life.  相似文献   

15.
目的:探讨最大长度序列(maximum length sequences)脑干听觉诱发电位(以下简称MLS BAEP),对窒息新生儿早期检查判断其缺氧缺血性脑病(HIE)及程度的意义。方法:对26例正常新生儿和103例窒息新生儿于出生后3 d内分别行常规脑干听觉诱发电位(常规BAEP)和MLS BAEP检查。将103例窒息患儿,分组为无HIE组17例,轻度HIE组37例,中度HIE组31例,重度HIE组18例。所得检查波形定位分析后取I,III,V波潜伏期及振幅,I-III,III-V,I-V峰间期作为评价指标。结果:在常规BAEP和MLS BAEP中,V波潜伏期,I-III,III-V,I-V峰间期随HIE程度的加重逐渐延长的差异较明显,尤其在MLS BAEP中随声刺激速度的加快这种差异也越显著。各亚组与正常组两两比较中,轻度和/或中度HIE组的I-III,III-V峰间期在常规BAEP无差异,而在MLS BAEP中差别有统计学意义,并随声刺激速度增加统计学差异越显著。结论:MLS BAEP通过提高声刺激速度加大对听觉神经的负荷,为窒息缺氧后脑损伤的电生理检查提供了一个更敏感的方法,并对判断这种脑功能障碍有一定量化意义。  相似文献   

16.
目的:探讨重度高胆红素血症新生儿总胆红素/白蛋白比值(B/A比值)、酸中毒与脑干听觉诱发电位(BAEP)异常的关系及其临床意义。方法:纳入2008年11月至2009年10月间重度高胆红素血症患儿967例。按照BAEP的结果,分为BAEP正常组(799例)和BAEP异常组(168例)。对B/A比值、酸中毒与BAEP的关系分别进行单因素分析,再根据日龄因素分别进行分层χ2检验。结果:单因素分析结果显示,BAEP异常组较BAEP正常组具有更低的pH值和BE值以及更高的B/A比值,差异有统计学意义。分层χ2检验分析结果显示,对于重度高胆红素血症任何日龄组的患儿,当存在酸中毒或当B/A比值>1时,其BAEP异常的发生率均较对照组增高,差异均有统计学意义。结论:高B/A比值、酸中毒是重度高胆红素血症患儿发生BAEP异常的危险因素,且对于任何日龄段的患儿均是如此。故对于任何日龄组的重度高胆红素血症患儿,当存在上述危险因素时,应尽快纠正其酸中毒,降低B/A比值,以降低胆红素听力损伤的发生。  相似文献   

17.
Brainstem auditory evoked potentials (BAEPs) are a sensitive indicator of bilirubin neurotoxicity. Somatosensory evoked potentials (SEPs) have been proposed as another measure of toxicity, though the lemniscal pathways that generate the SEP are not involved in kernicterus. In 16 to 17-d-old jaundiced (jj) Gunn rats, serial BAEPs and SEPs were obtained up to 8 h after acute bilirubin toxicity. jjs were injected with 150 mg/kg sulfadimethoxine to displace bilirubin into brain tissue (n = 8); littermate controls were jjs given saline (n = 4) and nonjaundiced given sulfadimethoxine or saline (n = 7). After anesthesia, BAEP and SEP recordings were obtained at baseline and serially after injection. SEPs to median nerve stimulation were recorded from surface electrodes over the brachial plexus (Erb's) and contralateral parietal cortex, and subtracted to obtain central conduction time (CCT). There were no statistically significant different baseline values between groups. Baseline BAEP I, I-II, and I-III were 1.22 +/- 0.13, 1.11 +/- 0.12, and 2.10 +/- 0.15 ms, and SEP Erb's and CCT were 1.48 +/- 0.20 and 5.59 +/- 0.50 ms, respectively (n = 19). At 6.8 +/- 1.5 h after injection BAEP I, I-II, and I-III increased 0.10 +/- 0.08, 0.18 +/- 0.17, and 0.56 +/- 0.33 ms over baseline, respectively (p = 0.005, 0.01, and 0.001, respectively, paired, 1-tailed t-tests), in experimental but not control groups. SEP Erb's decreased slightly, -0.06 +/- 0.04 ms in experimental and -0.08 +/- 0.08 ms in control groups, while CCT did not change significantly. BAEPs were completely abolished in two jjs with no SEP changes. When injection of sulfonamide induced significant peripheral and central BAEP abnormalities in jaundiced rats, no SEP abnormalities occurred. SEPs assess proprioception but not other somatosensory function or sensory integration. The results demonstrate the selectivity of acute bilirubin toxicity for the auditory nervous system.  相似文献   

18.
Somatosensory evoked potentials (SEP) were used to objectively evaluate sensory function in neonatal sheep after experimental fetal surgery. Posterior tibial (PTN) and ulnar (UN) nerves were stimulated electrically and averaged SEP were recorded from scalp electrodes placed over the somatosensory cortex. Animals with experimentally-created myelomeningocele (MMC) showed no SEP to PTN stimulation, but normal SEP to UN stimulation. In-utero repair of the MMC resulted in preservation of neurologic function and normal PTN SEP. In-utero thoracic spinal-cord transection resulted in no regeneration, and no SEP to PTN stimulation. In-utero unilateral transection of the sciatic nerve, even with attempted repair, resulted in little or no regeneration and absent or grossly abnormal PTN SEP from the affected side. In summary, the SEP technique provides valuable information concerning preservation of sensory function in a variety of experimentally created neurologic abnormalities and can aid in functional evaluation of experimental therapeutic fetal interventions. Accepted: 16 July 1999  相似文献   

19.
目的 探讨脑干听觉诱发电位(brainstem auditory evoked potential,BAEP)对手足口病重症病例神经系统损害的早期诊断价值.方法 本研究通过对297例手足口病患儿进行BAEP检测,之后按照严重程度分级及年龄进行分组比较,手足口病普通病例、年龄<3岁为A组(n=80),重症病例重型、年龄<3岁为B组(n=94),普通病例、年龄≥3岁为C组(n=38),重症病例重型、年龄≥3岁为D组(n=85).回顾性分析各组脑电图(electroencephalogram,EEG)、头部MRI的检测结果,并与BAEP结果进行比较.结果 (1)B组BAEP异常率(18/94,19.15%)高于A组(3/80,3.75%),D组BAEP异常率(13/85,15.29%)高于C组(1/38,2.63%),差异有统计学意义(P<0.05).(2)B组EEG异常率偏低(2/94,2.13%),A组无一例EEG异常.(3)D组EEG异常率(49/85,57.65%)高于C组(6/38,15.79%) (P <0.05),且高于D组BAEP异常率.(4)B组MRI异常率(9/94,9.57%)高于A组(1/80,1.25%)(P<0.05),D组MRI异常率(9/85,10.59%)高于C组(0).(5)全部手足口病重症病例重型患儿的BAEP异常率(31/179,17.32%)高于MRI异常率(18/179,10.06%) (P<0.05).结论 BAEP检测可为手足口病重症病例神经系统损害的早期诊断提供客观依据.  相似文献   

20.
目的:通过研究窒息患儿脑干听觉诱发电位(BAEP)异常与神经元特异性烯醇化酶(NSE)的相关性,探讨NSE对早期了解窒息患儿听神经损害的临床意义和应用前景。方法:选择该院窒息足月新生儿52例作为研究组,根据Apgar评分以及是否合并缺氧缺血性脑病(HIE)分为单纯轻度窒息组23例、单纯重度窒息组15例和窒息合并HIE组14例。采用双盲试验在生后7 d同一时间检测BAEP和NSE,初次BAEP检测异常者在生后3个月同一时间进行第2次BAEP和NSE检测。正常足月新生儿30例作为对照组。结果:窒息患儿两次听力损伤检出率分别为50.0%,21.2%。BAEP两次检出异常率,重度窒息组(63.3%,26.3%)与轻度窒息组(36.9%,5.9%)比较,差异均有显著性意义(P<0.05),HIE组(57.1%,31.3%)与重度窒息组比较差异无显著性意义。各研究组NSE水平均明显高于对照组(P<0.01),重度窒息组为26.70±2.34 μg/L明显高于轻度窒息组的17.18±3.16 μg/L,差异有显著性意义(P<0.01),HIE组为27.00±2.01 μg/L,与重度窒息组比较差异无显著性意义。BAEP异常组NSE水平为25.69±4.12 μg/L高于BAEP正常组的17.15±3.09 μg/L(P<0.01),NSE水平随着V波反应阈值的增高而增高(P<0.05)。结论:血清NSE水平与BAEP密切相关,可作为早期评估窒息患儿听神经损害和判断预后的指标之一。  相似文献   

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