脑震荡的多形式诱发电位研究进展

脑震荡占颅脑外伤的80%〔1〕,系临床上的常见多发病;多数患者以头昏、头痛、眩晕、记忆力下降、焦虑、抑郁等为主诉〔2,3〕,而神经系统无定位体征,给实际医疗工作带来了一定困难。自Bakay等报道脑震荡后脑组织超微结构呈明显时序性变化以来,国内外学者对其病理、生理等诸方面进行研究〔4,5〕;现就有关脑震荡的多形式诱发电位研究介绍如下。1　脑干听觉诱发电位(brain-stemauditoryevokedpotential,BAEP)　　听觉诱发电位是声音信号刺激耳后在头部记录的产生于听觉神经通路不同部位的电位。依潜伏期分为10ms以内的BAEP、10～50ms的中潜伏…     

脑震荡患者磁刺激运动诱发电位观察

目的：探讨脑震荡患者经颅磁刺激运动诱发电位（MEP）变化。方法：对28例脑震荡急性期患者及20例健康者行经颅磁刺激MEP检测，同时对12例患者3月后复查。结果：脑震荡患者皮层刺激阈强度增高，随着病情好转逐渐改善；测试过程中患者和对照组未出现明显不良反应。结论；脑震荡患者急性期大脑皮层存在不同程度的兴奋性降低，随病情好转逐渐改善；单脉冲磁刺激是一种安全的电生理检测手段。     

脑干听觉诱发电位在脑震荡的诊断作用

目的 观察脑震荡患者脑干听觉诱发电位(BAEP)变化情况.方法 将60例脑震荡患者的脑干听觉诱发检查结果进行分析,并与CT检查做比较.结果 60例脑震荡病人BAEP异常大约为83%,CT检查异常率为21%.结论 脑干听觉诱发电位对脑震荡的早期诊断和脑干功能状况的疗效评估只有重要的价值.     

脑震荡的脑干诱发电位特点及其临床法医学应用探讨

目的探讨脑震荡脑干诱发电位的特点及临床法医学应用。方法对15例脑震荡伤者进行脑干诱发电位检测和分级评估。结果脑震荡伤者脑干诱发电位的异常率为100%,其中脑干段电反应异常率达86.7%,提示脑震荡伤者存在脑干功能障碍。BAEP的分级以Ⅲ级为主。结论脑干诱发电位对脑震荡损伤的认定有一定的价值。     

脑电图检查对脑震荡病人的临床意义

绝大多数脑震荡病人无器质性损伤及显著的解剖学和结构组织损害。但病人伤后可出现头痛、头晕、耳鸣、失眠、记忆力减退、恶心等一系列症状,部分病人数月内仍有头痛、记忆力减退等脑损伤后综合征表现。笔者近年来对120例临床诊断为脑震荡病人进行脑电图     

825例脑震荡脑电图分析

我院１９８９年６月～１９９８年６月共检查外伤致脑震荡脑电图（ＥＥＧ）８２５例，发现异常９１例，占１１％；属正常范围ＥＥＧ的７３４例中，显示低幅快波β型的有５８６例，占７１－０３％。现报道如下。１　材料与方法１－１　临床资料　本组８２５例均来源于我院神经外科门诊及住院患者，其中住院１３８例，门诊６８７例。男６１３例，女２１２例；年龄６个月～７２岁。致伤原因：车祸伤３８４例，斗殴伤２５１例，砸伤６８例，坠落伤和碰伤１２２例。临床表现：８２５例均有明确的头部外伤史和短暂的昏迷史（１～３０ｍｉｎ），伤后…     

癫痫患者P50听觉诱发电位的研究

目的 探讨Ｐ５０在癫痫患者检测中的临床价值。方法 对２５例癫痫患者进行Ｐ５０测试,分析Ｐ５０波的潜伏明和波幅以及在不同刺激频率时Ｐ５０波幅的比率。选择年龄、性别２与患者组相匹配的２５名健康受试者对照组,结果 癫痫患者组Ｐ５３波的潜伏期较长,波幅则显著减低,其中以１８例颞叶癫痫２表现显著,７例额叶癫痫２不明显。刺激频率稍加快时,患者组Ｐ５０的波幅比率明显减小。结论Ｐ５０波的潜伏期和以应异常与颞叶功能     

脑卒中患者中医辨证与视觉诱发电位的相关研究

目的：探讨脑卒中各中医证型与视觉诱发电位（VEP）的关系。方法：38例脑梗死患者辨证分为肝阳上亢组18例和其他证型组20例,正常组为健康人15例,均采用Nicolet Viking IV型肌电诱发电位仪检测VEP,刺激模式为全视野黑白棋盘格翻转图形双眼分别刺激。结果：与正常组及其他证型组比较,肝阳上亢组VEPP100潜伏期延长（P〈0.05）,VEP异常率较高,差异有统计学意义（P〈0.05,P〈0.01）。结论：脑卒中肝阳上亢型VEP存在异常改变,可作为脑卒中中医辨证分型和中医治疗的客观指标。     

职业性噪声聋患者听觉诱发电位的初步研究

目的探讨听觉诱发电位与噪声性聋易感性的关系。方法使用纯音测听(PTA)、多频稳态诱发电位(ASSR)、脑干诱发电位(BAEP)、40 Hz听觉诱发电位(40 Hz AEP)检测45例职业性噪声聋患者(轻度聋24例,中度聋21例)和25例听力正常者(对照组),对PTA结果与ASSR、BAEP、40 Hz AEP反应阈检测结果进行对比研究。结果对照组PTA、ASSR、BAEP、40 Hz AEP值与轻度和中度噪声聋比较,差异均有统计学意义(均P<0.05),PTA阈值与各听觉诱发电位反应值均存在正相关关系(r=0.722、0.670、0.835)。结论 ASSR、BAEP、40 Hz AEP检测能为职业性听力损伤的诊断提供客观、公正的依据。     

Sensory evoked potentials in patients with affective disorders accompanying suicidal behavior

目的：探讨伴自杀行为史的情感障碍患感觉性诱发电位的特点及其临床意义。方法：应用美国尼高力公司Spirit脑诱发电位仪,记录了39例抑郁相、22例躁狂相患和33名正常对照的视觉诱发电位（VEP）、听觉诱发电位（AEP）和体感诱发电位（SSEP）。结果：1。与正常对照组相比,抑郁相和躁狂相组均出现感觉性诱发电位主成分波幅降低,且抑郁相VEP/P2潜伏期延迟。2、伴自杀行为史的抑郁相患VEP/P3波幅降低较明显,而伴自杀行为史的躁狂相患VEP/P2波幅和AEP/P2波幅降低较明显。3.与不伴自杀行为史的情感障碍患相比,伴自杀行为史的情感障碍患VEP/P3波幅和SSEP/P3波幅降低较明显。结论：情感障碍患的感觉性诱发主成分波幅降低且与患有无自杀行为史有关;与自杀行为相关的生物学指标研究中需进一步重视感觉性诱发电位波幅降低的特点。     

45例三叉神经痛患者体感诱发电位的分析与探讨

目的：探讨三叉神经痛患者三叉神经体感诱发电位（TSEP）的波形特征,临床价值以及手术和药物对TSEP的影响。方法：采用丹麦产DISA—2000M多导诱发肌电仪,对45例原发性三叉神经痛患者进行健侧和患侧的TSEP检查,以正常人TSEP数据作为对照,对结果进行对比分析。结果：（1）原发性三叉神经痛患者的健侧患侧比较,潜伏期N1、P3、N3及波幅N2P3、N3P4差异明显,有统计学意义（P〈0.05）。患者与健康者比较,潜伏期P1、N1、P2、N2、P3及波幅P1N1、N1P2、P2N2、N2P3、N3P4差异明显,有统计学意义（P〈0.05）。（2）原发性三叉神经痛患者TSEP高幅电位提前,潜伏期延迟。（3）手术后TSEP波形消失,药物对TSEP影响不大。结论：潜伏期N1、P3的延迟及波幅N2P3的升高,N3P4的降低可以作为原发性三叉神经痛的诊断标准。     

Determination of Median Nerve Somatosensory Evoked Potentials in 27 Patients with Hemiplegia

Summary: Twenty-seven in-patients with hemiplegia following brain injury were studied by using up per extremity median nerve somatosensory evoked patentials (SVEP), Brunnstrom assessment in hemiplegic hand and assessment of the patients‘ activities of daily lioing (ADL) (Barthel index). The upper extremity median nerve SEP on the affected and normal sides was determined. By using Kovin dba standard, upper extremity median nerve SEP was graded in accordance with N20. The correla tion between the differences of SEP N20 amplitude and the latencies on the both sides and the Barthel index scores was analyzed. A Spearman correlation analysis was made between the median nerve SEP N20 grades and Brunnstrom stages in hand or ADL on the affected side. The results showed that up per extremity median nerve SEP grades were positively correlated with those of the Brunnstrom stages in hand (r1 =0. 6925, P1＜0. 01). The correlation coefficient between SEP N20 grades and patients‘ ADL grades was r2= 0. 5015, P2＜0.01. It was concluded that upper extremity median nerve SEP could be used as a sensitive electrophysiological predictor to clinically assess hemiplegic hand function. SEP N20 might play a role in predicting the ADL of the patients with hemiplegia to some extent, but could not be used as a sensitive predictor to directly observe and predict the ADL of the patients.     

海洛因依赖者的脑干听觉诱发电位和事件相关电位P300研究

目的探讨海洛因依赖者的脑干听觉诱发电位(BAEP)和事件相关电位(ERP)P300的变化特点及其应用.方法使用意大利Galileo Sirius数字化32导脑诱发电位仪对32例海洛因依赖者BAEP和P300检查,并与30例正常人比较.结果 (1)海洛因依赖者BAEP的波Ⅱ-波Ⅶ绝对潜伏期[依次为(2.67±0.12)μV,(3.82±0.16)μV,(4.95±0.17)μV,(5.11±0.12)μV,(6.61±0.17)μV,(7.52±0.14)μV]较正常对照组延长(P＜0.05),绝对波幅[依次为(0.16±0.10)μV,(0.29±0.09)μV,(0.36±0.12)μV,(0.41±0.11)μV,(0.26±0.11)μV,(0.27±0.10)μV]降低(P＜0.05),而波I差异无显著性(P＞0.05).(2)海洛因依赖者P300的潜伏期M[(89.47±15.02)ms]较正常人缩短(P＜0.05),潜伏期P3[(320.23±19.01)ms]较正常人延长(P＜0.05).结论海洛因依赖者存在一定程度的脑功能损害,其BAEP和P300变化特点既可作为辅助诊断依据又可为海洛因的戒断分析时提供神经电生理基础.     

Multimodality evoked potentials in patients with delayed encephalopathy after acute carbon monoxide poisoning

Objective： To evaluate the diagnostic and prognostic values in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods： The tibial nerve somatosensory evoked potentials （SEPs）, vision evoked potentials （VEPs）, and brain stem audition evoked potentials（BAEPs） were performed in 32 healthy adults and 43 patients with delayed encephalopathy after acute carbon monoxide poisoning. Results： This paper indicated abnormalities of tibial nerve SEPs in 31 patients （31/43, 72.1%）, VEPs in 17 patients （17/28, 60.7%）, and BAEPs in 14, patients （14/43, 32.6%）. These results showed that the greatest diagnostic value was SEPs, followed by VEPs and, BAEPs with the lowest sensitivity. Conclusion： Multimodality evoked potentials （EPs） can be used for evaluating the diagnostic and prognostic values in cases of delayed encephalopathy after acute carbon monoxide poisoning.     

Brainstem auditory evoked potentials in patients with delayed encephalopathy after acute carbon monoxide poisoning

Objective:To evaluate the changes of brainstem auditory evoked potential (BAEP) in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods: BAEPs were performed in 32 controls and 40 patients. Wave Ⅰ , Ⅱ , Ⅲ ,Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies were measured, respectively. Results: Abnormalities of BAEPs in 13 patients (13/40, 32 ％). Among the13 abnormal BAEPs, 3 displayed prolongation of latency to waves in one side, no potential in another side; 5 displayed a similar abnormality which was bilateral prolongation of latency to waves ;and another 5 displayed unilateral latency delay. Compared wave Ⅰ , Ⅱ , Ⅲ , Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies in the patients and the controls, there were no significant differences (P＞0.05). Conclusion: BAEPs can be used for evaluating the diagnostic and prognostic values in the cases of delayed encephalopathy after acute carbon monoxide poisoning.