脑干听觉诱发电位及体感诱发电位联合检测对昏迷患者预后的判断价值

目的:研究脑干听觉诱发电位(BAEP)、短潜伏期体感诱发电位(SSEP)联合检测对昏迷患者预后的判断.方法:对30例昏迷患者分别在病程的急性期、3个月、6个月时作BAEP、SSEP检测.结果:急性期BAEP检测30例均异常,其中双侧异常17例,单侧异常13例,表现为Ⅰ波后各波潜伏期(PL)延长或波形消失,波间潜伏期(IPL)延长.Ⅲ波、Ⅴ波存在者预后好,消失者呈重残、植物状态或死亡.急性期SSEP正常6例,异常24例(80%),表现为皮层电位异常,N20波缺失,PL延长,波幅严重降低,波形离散.24例SSEP异常者中预后良好11例,预后不良13例(其中5例死亡)(54%).17例BAEP严重异常者SSEP也同样表现为严重异常.结论:BAEP、SSEP联合检测能分别反映脑干及大脑的功能,能早期判断昏迷患者的预后,尤其SSEP皮层电位N20异常程度可客观判断脑病变的程度,具有重要的临床价值.     

脑干听觉诱发电位测试参量重要性的探讨

对国内外各家ＢＡＥＰ资料进行统计分析，以及对４１例健康人（１５～５６岁，男１９例，女２２例）８１只听力正常耳分别用短声和滤波短声进行ＢＡＥＰ测试，结果表明，在ＢＡＥＰ正常值检测中，刺激声是影响其结果的最重要参量之一。因此，各实验室应有自己的正常值，如果测试条件及仪器符合规格。那么在测试方法学和测试参量统一的条件下，各实验室的ＢＡＦＰ正常值应该是可以相互参考的。     

Visual evoked potential & brainstem auditory evoked potentials in acute attack & after the attack of migraine

PURPOSE: To study the effect on visual evoked potential (VEP) and brainstem auditory evoked potential (BAEP) at time of acute attack and after 7 days of the attack of migraine. MATERIAL AND METHODS: We studied BAEP and pattern reversal VEP in 25 patients during acute attack and after 7 days of the attack. The diagnosis of migraine was established according to criteria given by international headache society (IHS). Peak and interpeak latencies (IPL's) of BAEP and P100 latency of VEP were the main criteria to judge abnormalities. RESULTS: There were prolonged peak and interpeak latencies in BAEP and prolonged peak latency (P100) in VEP at the time of acute attack of migraine. The data of these abnormal recording were highly significant. After 7 days when the attack was over, we recorded the BAEP and VEP again. The observation obtained at this time was comparable to normal values. CONCLUSIONS: From the observation of this study we can safely conclude that in acute attacks of migraine there may be some pathological changes in different areas of brain and brainstem, producing changes in evoked potential which are statistically highly significant. However, these changes are reversible, as the values of BAEP & VEP on 7th day after the attack were comparable to those observed in normal healthy control.     

Visual and brainstem auditory evoked potentials in hereditary motor-sensory neuropathy

Visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) were recorded in 57 children and adults with hereditary motor-sensory neuropathy (HMSN); 37 of them were diagnosed as type I (demyelinating) and 20 as type II (axonal). None of the patients presented central nervous system involvement. The results were compared with VEP and BAEP records of 12 adults with Guillain-Barré syndrome (GBS) and 40 healthy controls. Above 30% of all patients with HMSN I showed delayed latency of the VEP. These abnormalities were less expressed in HMSN II. Abnormal BAEP were observed in almost 50% of patients with HMSN I and HMSN II with nearly the same frequency in both types but more pronounced in HMSN I. The most common feature was prolongation of the I-III interpeak latency (JPL). The VEP and BAEP changes could be present simultaneously in the same patient (mainly in HMSN I) or separately. More often the abnormalities were observed in the adult patients. Normal VEP and BAEP values were present in all patients with GBS. The results strongly suggest the subclinical optical and auditory pathways involvement in HMSN patients.     

Modulation of steady-state auditory evoked potentials by cerebellar rTMS

Steady-state auditory evoked responses (SSAER) obtained via electroencephalography (EEG) co-vary in amplitude with blood flow changes in the auditory area of the cerebellum. The aim of the present EEG study was to probe the cerebellar role in the control of such SSAER. For this purpose, we investigated changes in SSAERs due to transient disruption of the cerebellar hemisphere by repetitive transcranial magnetic stimulation (rTMS). SSAERs to click-trains of three different frequencies in the gamma-band (32, 40 and 47 Hz) were recorded from 45 scalp electrodes in six healthy volunteers immediately after 1-Hz rTMS and compared to baseline SSAERs assessed prior to magnetic stimulation. Cerebellar rTMS contralateral to the stimulated ear significantly reduced the amplitude of steady-state responses to 40-Hz click-trains and showed a tendency to reduce the amplitude to 32-Hz click-trains. No effects were observed for 47-Hz click-trains, nor for magnetic stimulation of the cerebellum ipsilateral to auditory stimulation or after sham stimulation. Our results suggest that interference with cerebellar output by rTMS modifies functional activity associated with cortical auditory processing. The finding of maximum effects on 40-Hz SSAERs provides support to the notion that the cerebellum is part of a distributed network involved in the regulation of cortical oscillatory activity and points at some frequency-specificity for the control of auditory-driven neuronal oscillations.     

海风藤对犬脑干缺血后BAEP的影响

目的观察海风藤对犬脑干缺血后脑干听觉诱发电位（ＢＡＥＰ）的影响。方法建立犬脑干缺血模型，给药组和对照组各２０只犬，分别于阻断基底动脉前３ｈ向十二指肠注入海风藤溶液（按０．３ｇ／ｋｇ）和等体积生理盐水，于缺血前和缺血后０．５、３、６和１２ｈ分别记录ＢＡＥＰ。结果给药组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波潜伏期和Ⅰ－Ⅲ、Ⅲ－Ⅴ、Ⅰ－Ⅴ波峰间期明显缩短。结论海风藤可改善犬脑干对缺血的耐受程度，减小半暗带的范围，减轻病变的程度。     

Modelling and recognition of brainstem auditory evoked potentials using Symlet wavelet

In Brainstem Auditory Evoked Potentials (BAEPs) extraction systems, BAEP recognition by determining wave latencies I, II, III and IV/V is an importantant stage for pronostic assistance. We suggest in this paper a new approach for BAEP recognition. The recognition is based on modelling BAEP using wavelet transform; latencies are then automatically measured. We show that the application of a sixth-order Symlet wavelet gives good results.     

窒息新生儿脑干听觉诱发电位的观察

目的：探讨窒息对新生儿的听觉和脑干功能的影响,方法：对55例窒息新生儿进行脑干听觉诱发电位（BAEP）检测,结果：BAEP的异常率为51％,主要表现在I,V波峰潜伏期延长,I－V,Ⅲ-Ⅴ峰间期延长及Ⅲ-Ⅴ/ⅠⅢ＞1的和反应阈升高。结果：窒息新生儿可有听力损失和中脑下部的损害,BAEP对了解新生儿早期听力及脑干功能障碍有重要价值。     

Detection of brainstem auditory evoked potential by adaptive filtering

A method of detecting brainstem auditory evoked potential (BAEP) using adaptive signal enhancement (ASE) is proposed and tested in humans and cats. The ASE in this system estimates the signal component of the primary input, which is correlated with the reference input to the adaptive filter. The reference input is carefully designed to make an optimal and rapid estimation of the signal corrupted with noise, such as ongoing EEG. With a good choice of reference input, it is possible to track the variability of BAEP efficiently and rapidly. Moreover, the number of repetitions required could be markedly reduced and the result of the system is superior to that of ensemble averaging (EA). To detect BAEP in cats, only 30 ensemble averages are needed to obtain a reasonable reference input to the adaptive filter, and, for humans, 350–750 ensemble averages are sufficient for a satisfactory result. Using the LMS adaptive algorithm, individual BAEP can be obtained in real-time.     

高胆红素血症新生儿脑干听觉诱发电位的研究

目的 :观察新生儿高胆红素血症对外周及脑干听觉传导系统的影响及机制。方法 :根据血清胆红素水平把 4 6例新生儿分成A组 (2 9例 ,5 8耳 ,血清间接胆红素小于 342 μmol/L)和B组 (17例 ,34耳 ,血清间接胆红素大于 342 μmol/L)两组进行脑干听觉诱发电位检测。 结果 :AB两组患儿分别有15耳和 2 2耳出现Ⅴ波反应阈轻度升高 ,两组相比 ,差异有显著意义 (P <0 .0 1)。与A组比较 ,B组患儿BAEP异常率显著增高 (P <0 .0 1) ,其中Ⅰ波、Ⅴ波异常率 ,Ⅰ -Ⅴ间期异常率显著增高 (P <0 .0 1) ,Ⅲ波及Ⅰ -Ⅲ峰间期、Ⅲ -Ⅴ峰间期异常率差异无显著意义 (P >0 .0 5 )。结论 :高胆红素血症可导致新生儿听神经损害 ,血清间接胆红素水平与BAEP异常程度有直接关系     

高危新生儿的脑干听觉诱发电位观察

目的：探索早期发现高危新生儿听力损害及脑干损害的诊断方法。方法：肌电仪记录２５例正常新生儿和２７例高危新生儿的ＢＡＥＰ，并加以比较。结果：高危新生儿组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波出波率及波幅均比正常对照组明显降低；Ⅰ波潜伏期明显延长。结论：ＢＡＥＰ可灵敏判断高危新生儿的听功能及脑干功能，对早发现高危新生儿的听力和脑干损害，尽早治疗有重要意义。     

亚临床肝性脑病患者BAEP的研究

目的:探讨脑干听觉诱发电位(BAEP)对评价亚临床肝性脑病患者早期脑力能状况价值.方法:对94例经临床确诊的肝硬化失代偿期的患者进行BAEP检测,并与100例正常对照者进行对比分析.结果:疾病组Ⅰ、Ⅲ、Ⅴ波的潜伏期(PL)及Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波波峰间期(IPL)均延长.期中以Ⅲ、Ⅴ波的潜伏期(PL)及Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波波峰间期(IPL)延长较明显,与正常对照组比较有显著差异(P＜0.01).结论:BAEP对亚临床肝性脑病患者患者工能的评价提供了一项客观指标,有助于临床早期诊断和治疗.     

犬脑干缺血后脑干听觉诱发电位的研究

建立犬脑干局灶性缺血模型，观察脑干局灶性缺血后脑干听觉诱发电位（ＢＡＥＰ）的变化。结果发现犬脑干缺血０．５、１、１．５、３、６和１２ｈ缺血组（ＩＳ）ＢＡＥＰ的Ⅰ、Ⅲ、Ｖ各波潜伏期（ＰＬ）及Ⅰ－Ⅲ、Ⅲ－Ｖ、Ⅰ－Ｖ波的峰间期（ＩＰＬ）与假手术组（ＳＨ）相比较均非常明显地延长（Ｐ＜０．０１），以１～１．５ｈ延长最显著（ｒ＜０．０１），３ｈ后各值逐渐缩短。提示ＢＡＥＰ可反映犬脑干缺血后的脑干损害，可客观地评价脑干功能。     

婴儿痉挛症脑干听觉诱发电位的奇异性初步分析

目的运用建立在子波变换基础上的Lipschitz指数和模极大值两种奇异性检测方法分析婴儿痉挛症患儿脑干听觉诱发电位,试图解释婴儿痉挛症患儿智能迟滞的原因,从神经电生理的信息传递的角度来证明脑干是责任病灶。方法本实验病例分为2组,正常组12例,平均年龄(6.325±3.210)岁;婴儿痉挛症组13例,平均年龄(4.638±3.986)岁。所有病例均行脑干听觉诱发电位检查,并用建立在子波变换基础上的Lipschitz指数和模极大值两种奇异性检测方法进行分析。结果Lipschitz指数尖峰在正常幼儿0～2ms和5～7ms各出现1次,在婴儿痉挛症患儿尖峰出现在0～2ms和5～7ms之后。正常幼儿模极大值在一定范围内连续性好,而在婴儿痉挛症患儿则中断。结论研究发现在婴儿痉挛症患儿的脑干、尤其是上部脑干对上行传导的信息耦合性差,从而影响患儿的智能发育。     

脑干听觉诱发电位在耳外伤患者中的应用

目的 :分析耳外伤患者脑干听觉诱发电位 (BAEP)的改变及特点。方法 :对 72例耳外伤患者中 91只患耳进行BAEP检测 ,测定Ⅰ、Ⅲ、Ⅴ各波潜伏期 (PL)、峰间潜伏期 (IPL)、两耳间PL或IPL之侧间差 (ILD)等数值。结果 :病例组Ⅰ、Ⅲ、Ⅴ波PL明显延长 ,与对照组相比差异有非常显著意义 (P <0 .0 1) ,IPL无明显改变 (P >0 .0 5 ) ,提示其损害主要为蜗前传导障碍。结论 :BAEP检测是一项客观敏感的神经电生理学指标 ,对于评价耳外伤后的听觉传导通路功能状况具有重要价值。     

耳外伤患者的脑干听觉诱发电位分析

目的：分析耳外伤患者脑干听觉诱发电位（BAEP）的表现。方法：对108例耳外伤患者进行BAEP检测,测定Ⅰ、Ⅲ、Ⅴ各波潜伏期（PL）、峰间潜伏期（IPL）、两耳间PL或IPL之侧间差（ILD）等指标。结果：108例（141耳）中异常91耳,异常率为64．5％。主要异常表现为病例组Ⅰ、Ⅲ、Ⅴ波PL明显延长,与对照组相比,差异有非常显著意义（P〈0．01）,IPL则无明显改变（P〉0．05）,Ⅴ波反应阈升高。结论：BAEP检测是一项客观敏感的神经电生理学检查法,对于评价耳外伤后的听觉传导通路功能状况具有重要价值。     

脑干听觉诱发电位检测在新生儿高胆红素血症中的临床意义

目的：观察高胆红素血症对新生儿的听觉和脑干功能的影响。方法：对60例高胆红素血症新生儿进行脑干听觉诱发电位(BAEP)检测，并以30名正常儿作对照。结果：高胆红素血症新生儿BAEP的异常率为55％。主要表现为Ⅰ、Ⅴ波分化不良或波形消失，Ⅰ、Ⅴ波潜伏期延长，Ⅰ—Ⅴ峰间期延长和反应阈升高。结论：新生儿高胆红素血症对其听力和中脑下部有一定程度损害，BAEP对了解新生儿听力及脑干功能障碍有重要价值。     

早产儿的脑干听觉诱发电位及听力检测

目的:探讨早产儿脑干听觉诱发电位(BAEP)的特征及听力损失情况.方法:对46例不同出生胎龄早产儿进行BAEP及听力检测,分析BAEP主要波形成分Ⅰ、Ⅲ、Ⅴ波的峰潜伏期(PL),波幅及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ峰问期(IPL).以单侧耳Ⅴ波反应阈值作为听反应阈.结果:以30例正常足月儿为对照,不同出生胎龄新生儿BAEP Ⅰ、Ⅲ、Ⅴ波的PL,Ⅰ～Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波的IPL比较差异有显著意义(P＜0.05).46例早产儿存在听力损失27例(59%),30例足月儿存在听力损失2例(7%),差异有非常显著意义(γ2=20.62,P＜0.01).胎龄＜30周的4例均发生听力损失(100%),且均为中重度以上听力损失;胎龄30～33周23例中,发生听力损失13例(68%),其中中重度以上听力损失者占37%;胎龄≥34～36 6周23例,发生听力损失10例(43%),其中中重度以上听力损失者占11%.不同胎龄组间发生听损失的差异有非常显著意义(x2=16.56,P＜0.01),中重度以上听力损失的发生率差异尤为显著(x2=27.6,P＜0.01).结论:胎龄是影响新生儿BAEP的重要因素,早产儿胎龄越小,听力损失的发生率越高,听损失的严重程度越重.