脑干听觉诱发电位对面肌痉挛微血管减压术中听力保护的应用

目的探讨面肌痉挛微血管减压（microvascular decompression,MVD）术中应用脑干听觉诱发电位（brain—stem auditory evoked potential,BAEP）监测,对减少术后听力损伤的应用价值。方法回顾性分析43例面肌痉挛患者术中BAEP波V波形的变化以及手术前后平均纯音听力阈值（pure tone average,PTA）的改变,经统计学分析得出术中V波潜伏期延长的警示阈值。结果MVD术中,在显露面神经和责任血管减压操作时,V波潜伏期延长最为显著。38例患者术后PTA增高小于20dB,V波潜伏期平均延长（0．60±0．43）ms。其余5例术后PTA增高大于20dB,V波潜伏期平均延长（1．07±0．35）聪。两组患者V波潜伏期延长时间存在差异（P〈0．05）。术中V波潜伏期延长大于0．6ms与患者术后听力损伤相关;术中V波潜伏期延长大于1．0ms与患者术后听力损伤密切相关。因此术中V波潜伏期延长警示闾值可设定为0．6ms和1．0ms。结论BAEP监护警示阈值有助于指导面肌痉挛MVD术操作,避免术中过度牵拉听神经,减少对其周围微循环的干扰,为术中保护听神经提供警示作用。     

脑干听觉诱发电位监护在脑干肿瘤手术中的应用研究

目的研究脑干及相应颅神经功能损伤时较敏感的电生理指标,为脑干肿瘤手术提供精确、准确和安全的术中监测手段。方法对18例脑干肿瘤病人,用同一进口监护仪于手术前、术中及术后分别进行脑干听觉诱发电位(BAEP)连续实时监护,测定手术操作对这些指标的影响。结果脑干肿瘤手术操作均可以引起BAEP改变,BAEP的Ⅰ、Ⅲ、Ⅴ波潜伏期(PL)及Ⅰ～Ⅴ、Ⅲ～Ⅴ峰间潜伏期(IPL)明显延长(P<0.01),Ⅴ波波幅明显降低(P<0.01),其中BAEP的Ⅴ波潜伏期及波幅改变最为显著。结论BAEP的Ⅴ波潜伏期延长和波幅下降是术中敏感的电生理指标,对其进行监护可为手术中及手术后避免神经功能损伤提供客观指标,降低手术伤残率,减少或避免病人手术后神经功能损伤。     

大鼠头颅侧向旋转脑损伤模型脑干听觉诱发电位的变化

目的探讨头颅侧向旋转致脑损伤大鼠模型脑干听觉诱发电位（BAEP）的变化及机制。方法成年大鼠20只，制作头颅瞬间侧向旋转脑损伤模型，测量头颅旋转前及旋转后6h的BAEP，测量电极置于颅顶左侧c2点，左耳予短暂click声刺激，右耳持续予噪声掩蔽，经1000次叠加平均，记录BAEP各波形的潜伏期、波间期和波幅值。结果大鼠头颅旋转后6h和Ⅴ波潜伏期、Ⅰ～Ⅲ和Ⅲ～Ⅴ波波间期明显较旋转前延长，Ⅰ和Ⅴ波波幅较旋转前明显降低，而旋转前后Ⅰ波潜伏期、Ⅰ～Ⅴ波波间期以及Ⅰ波波幅无显著差异。结论头颅瞬间侧向旋转可引起BAEP异常，此与脑干内特殊传导通路的破坏有关，其结构基础为脑干广泛神经轴索损伤。     

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.     

神经电生理监测在原发性面肌痉挛微血管减压术中的应用

目的 探讨神经电生理监测下微血管减压术治疗原发性面肌痉挛的疗效和安全性。方法 回顾性分析2015年10月至2018年10月收治的47例原发性面肌痉挛的临床资料。均经枕下乙状窦后入路神经内镜下进行微血管减压术,25例行脑干听觉诱发电位（BAEP）及侧方扩散效应（LSR）监测（监测组）,22例无术中电生理监测（对照组）。47例术后随访3个月。结果 监测组术前均引出LSR波;剪开硬脑膜后LSR波消失2例;打开桥小脑角池时LSR波消失1例;垫入Teflon棉片减压后LSR波消失19例,LSR波幅明显下降2例;手术结束后仍不消失1例。术中BAEP监测可见Ⅰ、Ⅲ、Ⅴ波波幅降低,潜伏期延长,以Ⅲ波消失、Ⅴ波波幅下降>50%、潜伏期>1 ms居多。术后2周,监测组和对照组总有效率无统计学差异（100.0% vs. 95.5%;P>0.05）。监测组术后并发症发生率（4.0%）明显低于对照组（18.2%;P<0.05）。监测组术后复发率（0%）明显低于对照组（9.1%;P<0.05）。结论 原发性面肌痉挛微血管减压术中应用电生理监测,有助于降低并发症发生率及复发率。     

听神经瘤术中神经电生理监护的应用分析

目的研究听神经瘤术中脑干及相应颅神经功能较敏感的电生理监测手段,以达到减少伤残率及提高颅神经的解剖及功能保留率。方法对28例听神经瘤病人,用同一监护仪于手术前、术中及术后分别进行脑干听觉诱发电位(BAEP)及肌电图连续实时监护,观察手术操作对它们的影响。结果听神经瘤手术操作均可以引起BAEP改变,BAEP的Ⅰ、Ⅲ、Ⅴ波潜伏期,Ⅰ-Ⅴ、Ⅲ-Ⅴ峰间潜伏期的明显延长(P<0.05),Ⅴ波波幅明显降低(P<0.05),其中BAEP的Ⅴ波潜伏期及波幅改变最为显著。当接近、触及、牵拉、刺激面神经时,肌电图出现突发的、双相或多相的高幅电位改变,而通过直接电刺激可定位面神经解剖,面神经的解剖及功能保留得以明显提高。结论BAEP的Ⅴ波潜伏期延长和波幅下降以及突发的双相或多相的高幅肌电图改变是听神经瘤术中敏感的电生理指标,对其进行监护,可为术中避免神经功能损伤及术后其功能预测提供客观指标,降低手术伤残率。     

后颅窝肿瘤患者脑干听觉诱发电位初步研究：20例MRI和CT对照分析

以 MRI 和 CT 为对照分析了20例脑干和小脑肿瘤患者脑干听觉诱发电位(BAEP)的检查结果,发现 BAEP 异常者19例,BAEP 正常者1例。BAEP 异常主要表现为:Ⅰ～Ⅶ各波消失,Ⅴ波波幅降低,波幅比Ⅴ/Ⅰ<1,波间期Ⅰ～Ⅲ、Ⅲ～Ⅴ和Ⅰ～Ⅴ延长,波间期比Ⅲ～Ⅴ/Ⅰ～Ⅲ>1,与 MRI 和 CT 结果对照分析表明除肿瘤本身以外,脑干受压移位、脑脊液通路受阻也是BAEP 异常、特别是病灶对侧异常的重要原因。     

脑干听觉诱发电位在面肌痉挛显微血管减压术中的应用价值

目的探讨脑干听觉诱发电位（BAEPs）V波潜伏期和（或）波幅的变化与面肌痉挛（HFS）显微血管减压术（MVD）后听力损失的应用价值。 方法选取中日友好医院神经外科自2015年9月至2019年8月行MVD治疗的HFS患者的临床资料，分析MVD始末BAEPs的V波潜伏期和波幅的变化以及手术前后听力状况的改变，听力学评估采用平均纯音听力阈值及言语识别率改变。根据美国耳鼻咽喉头颈外科学会分级方法，将术后患者听力分为听力未明显下降组和听力明显下降组。收集术中全程的BAEPs改变，并将BAEPs的V波术中改变分为：无显著异常，单纯V波潜伏期（LwV）延长>1.5 ms，单纯V波波幅（AwV）下降>50%，LwV延长>1.5 ms且AwV下降>50%，LwV延长>1.5 ms或AwV下降>50%，对5组分类模式下术后听力损伤程度与分组的相关性进行统计分析，并分析4组BAEPs改变对术后听力损伤的预测价值。 结果本研究纳入的1009例行MVD治疗的HFS患者中，943例患者听力未明显下降，66例患者术后听力异常，术中BAEPs监测波形无显著改变，术后出现听力下降5例（0.6%）；术中仅LwV延长>1.5 ms，术后出现听力下降4例（18.2%）；术中仅AwV降低>50%，术后出现听力下降19例（25.0%）；术中"LwV延长>1.5 ms且AwV降低>50%"，术后出现听力下降38例（64.4%）；术中"LwV延长>1.5 ms或AwV降低>50%"，术后出现听力下降61例（38.8%）。各组的阳性预测值比较，结果显示"LwV延长>1.5 ms且AwV降低>50%"最高；"LwV延长>1.5 ms或AwV下降>50%"组的敏感度最高；"LwV延长>1.5 ms且AwV下降>50%"组的特异度最强。 结论术中BAEPs监测可为MVD术者提供听力参考。术末V波潜伏期延长1.5 ms且波幅降低50%以上阳性预测值最高。术中根据BAEPs监测结果及时调整手术策略，可有效改善术后听力障碍的发生率。     

后颅窝肿瘤术中脑干听觉诱发电位监护

一、临床资料与方法 2001年2月至2002年7月间入院的后颅窝肿瘤20例,平均年龄28.6岁。行显微神经外科手术。静脉全麻,诱导用异丙酚、芬太尼、司可林,维持用异丙酚+利多卡因+氯胺酮。采用美国Nicolet Endeavor Bravo型术中监护系统进行脑干听觉诱发电位监测。所有数据采用SPSS软件,进行配对t检验。 二、结果 麻醉用药前后BAEP略有改变,麻醉后Ⅰ、Ⅲ、Ⅴ绝对潜伏期明显延长(P<0.05),平均延长0.201ms,而Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ波间距基本不变(P>0.05)。麻醉后20min、40min,各指标无统计学上的差异(P>0.05),麻醉后Ⅴ波     

电生理监测在原发性面肌痉挛MVD中的应用

目的 探讨电生理监测在原发性面肌痉挛（HFS）显微血管减压术（MVD）中的应用价值。方法 回顾性分析2012年1月至2022年9月MVD治疗的304例HFS的临床资料。103例（监测组）术中监测侧方扩散波（LSR）、脑干听觉诱发电位（BAEP）和面神经自由肌电图（EMG）,201例（对照组）术中未使用电生理监测。术后6个月按照Cohen痉挛强度分级评估疗效;术后1周、6个月记录面瘫、耳鸣、眩晕、听力受损等并发症情况。结果 103例中,95例面神经充分减压后,LSR完全消失,7例LSR波幅下降>50%,1例LSR波幅下降不明显;2例BAEP出现Ⅰ波波幅下降>50%,1例出现Ⅲ波潜伏期延长超过20%;61例术中监测到面神经EMG,其中波幅<100μV有54例,100～200μV有7例。术后6个月,监测组有效率（93.03%）与对照组（94.17%）无统计学差异（P>0.05）。术后1周,对照组面瘫（12.43%）、耳鸣（13.43%）、眩晕（20.40%）、听力受损（13.43%）发生率明显高于监测组（分别为4.85%、5.83%11.65%、4.85%;P<...     

脑干听觉诱发电位分级对脑创伤长期意识障碍患者清醒预测的价值

目的 探讨脑干听觉诱发电位(BAEP)分级标准对脑创伤后长期意识障碍患者清醒预测的价值.方法 分析93例脑创伤后长期意识障碍患者的BAEP表现,将BAEP分为3级:Ⅰ级为各波均正常;Ⅲ级为双侧V波PL异常、双侧Ⅲ～Ⅴ波IPL异常、单侧或双侧V波消失;Ⅱ级为除Ⅲ级之外的任何异常BAEP表现.以脑创伤后6个月作为判断是否清醒的时间标准.结果 Ⅰ级、Ⅱ级、Ⅲ级的清醒率分别为:79％、18％和0％.分级与清醒差异有统计学意义(r=-0.662,P＜0.001),分级越高,清醒越困难.BAEP分级标准对清醒预测的ROC曲线下面积为0.859,95％可信区间为(0.781～0.937).结论 BAEP分级能客观、准确地反映脑功能损伤程度和预测清醒的概率.     

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.     

Characteristics of brainstem auditory evoked potential of neonates with mild or moderate hyperbilirubinemia

BACKGROUND: Brainstem auditory evoked potential (BAEP) has been widely used to evaluate the functional integrity and development of injured auditory system and brain, especially to objectively evaluate the function of auditory system and brain stem of very young babies, such as neonates and sick babies. OBJECTIVE: To observe the changes of BAEP of neonates with hyperbilirubinemia, and to investigate the relationship of bilirubin concentration and BAEP. DESIGN: An observation experiment. SETTING: Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA. PARTICIPANTS: Fifty-eight neonates with mild or moderate hyperbilirubinemia exhibiting jaundice within 24 hours after born, who received the treatment in the Department of Pediatrics, the 309 Clinical Division, General Hospital of Chinese PLA between January 2004 and May 2007, were recruited in this study. The involved neonates, 31 boys and 27 girls, had gestational age of 37 to 46 weeks. They had no history of birth asphyxia, and were scored 8 to 10 points when born. Written informed consents of examination and treatment were obtained from the guardians of the neonates. This study was approved by the Hospital Ethics Committee. According to serum total bilirubin value, the neonates were assigned into 3 groups: low-concentration bilirubin group (n =16), moderate-concentration bilirubin group (n =27) and high-concentration bilirubin group (n =15). According to mean daily bilirubin increase, the subjects were sub-assigned into bilirubin rapid increase group (n =39) and bilirubin slow increase group (n =19). METHODS: After admission, all the neonates received drug treatment. Meanwhile, their 116 ears were examined with a myoelectricity evoked potential equipment (KEYPOINT) in latency, wave duration, amplitude and wave shape differentiation of each wave of BAEP. BAEP abnormal type was observed and abnormal rate of BAEP was calculated. MAIN OUTCOME MEASURES: ① Abnormal rate and abnormal type of BAEP. ② Latency of waves Ⅰ, Ⅲ　and Ⅴ, and wave duration of waves Ⅰ to Ⅲ, Ⅲ to Ⅴ, and Ⅰ to Ⅴ. RESULTS: Fifty-eight neonates with mild or moderate hyperbilirubinemia were involved in the final analysis. ①Abnormal type and abnormal rate of BAEP of neonates with hyperbilirubinemia: Among the 116 ears, unilateral or bilateral waves Ⅰ, Ⅲ, Ⅴ still existed. The latency of waves Ⅰ, Ⅲ and Ⅴ was +2.5 s longer than the normal level in 8, 4 and 15 ears, respectively. The wave duration of waves Ⅰ to Ⅲ and waves Ⅲ to Ⅴ was +2.5 s longer than the normal level in 6 and 14 ears, respectively. The wave duration of waves Ⅲ to Ⅴ was longer than that of ipsilateral waves Ⅰ to Ⅲ in 24 ears. The latency difference of wave Ⅴ between two ears was larger than 0.4 ms in 31 neonates with hyperbilirubinemia; The amplitude of wave Ⅴ to that of ipsilateral wave I was lower than 0.5 in 29 neonates. Totally 52 ears were abnormal, and the abnormal rate was 44.8%. One to two months later, 98% abnormal neonates with hyperbilirubinemia recovered. The abnormal rate in the low-, moderate-, and high-concentration bilirubin groups was 37.5%, 44.4% and 53.3%, respectively. ② Comparison of latency and wave duration of each wave of BAEP: Latency of waves Ⅰ, Ⅲ and Ⅴ, and wave duration of waves Ⅰ to Ⅲ and Ⅲ to Ⅴ were gradually prolonged in low-, moderate-, and high-concentration bilirubin groups, but significant difference did not exist between two groups (P > 0.05). ③ There were no significant differences in latency of waves Ⅰ, Ⅲ and Ⅴ, and wave duration of waves Ⅰ to Ⅲ, Ⅲ to Ⅴ and Ⅰ to Ⅴ between bilirubin rapid increase group and bilirubin slow increase group (P > 0.05). CONCLUSION: Auditory acuity and brainstem of neonates with mild or moderate hyperbilirubinemia are damaged to some extent. High-concentration bilirubin causes BAEP abnormality easily. Bilirubin increase and its concentration change are not consistent with nervous lesion degree.     

孤独症谱系障碍患儿婴儿期体格、神经心理发育及脑干听觉诱发电位特征

目的:探讨孤独症谱系障碍(ASD)患儿婴儿期体格、神经心理发育及脑干听觉诱发电位(BAEP)特征。方法:收集21例2～6岁ASD患儿(ASD组)在其1、3、6及12月龄时体格发育资料(体质量、身长和头围)、神经心理发育评估资料[包括智力发展指数(MDI)和精神运动发展指数(PDI)]及BAEP检测结果(包括Ⅰ、Ⅲ、Ⅴ波潜伏期及I-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ峰间期),并与63名同龄正常儿童(对照组)比较。结果:两组婴儿期各月龄体格发育水平比较差异无统计学意义(P>0.05)。神经心理发育评估显示,12月龄时ASD组MDI和PDI明显低于对照组(P均<0.01)。BAEP检测结果显示,1及3月龄时ASD组BAEPⅠ波、Ⅲ波、Ⅴ波潜伏期、Ⅰ-Ⅲ峰间期、Ⅲ-Ⅴ峰间期及Ⅰ-Ⅴ峰间期明显长于对照组(P<0.05或P<0.01)。ASD组异常频率最多的是V波潜伏期延长(47.2%)。结论:婴儿期早期(1～3月龄)持续V波潜伏期延长、12月龄时神经心理发育迟缓可能为ASD患儿早期特征性改变,可作为ASD早期预警指标之一。     

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.     

Changes of brainstem auditory and somatosensory evoked

Objective: to investigate the characteristics and clinical value of evoked potentials in late infantile form of metachromatic leukodystrophy. Methods: Brainstem auditory, and somatosensory evoked potentials were recorded in 6 patients, and compared with the results of CT scan. Results: All of the 6 patients had abnormal results of BAEP and MNSEP. The main abnormal parameters in BAEP were latency prolongation in wave I, inter-peak latency prolongation in Ⅰ-Ⅲ and Ⅰ-Ⅴ. The abnormal features of MNSEP were low amplitude and absence of wave N9, inter-Peak latency prolongation in Ng-N13 and N13-N20, but no significant change of N20 amplitude. The results also revealed that abnormal changes in BAEP and MNSEP were earlier than that in CT. Conclusion: The detection of BAEP and MNSEP in late infantile form of metachromatic leukodystrophy might early reveal the abnormality of conductive function in nervous system and might be a useful method in diagnosis.     

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。     

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.