脑干听觉诱发电位在新生儿胆红素脑病诊断中的价值

我们对28例胆红素脑病患儿进行了脑干听觉诱发电位（BAEP）检查，旨在探讨对该病诊断中的作用。 1 资料和方法 1．1对象为1999-05～2005-03我院新生儿科确诊的28例，男21例，女7例；日龄2～22d，胎龄37～42周，体重2500～4000g。均除外颅内出血、颅内感染、严重败血症、严重窒息、低血糖及代谢性疾病，无先天畸形、耳部疾患及耳毒性药物应用史。血清间接胆红素270．14～765．26μmol／L。28例中Rh溶血症4例，ABO溶血症14例，红细胞膜异常1例，胆汁粘稠综合征1例，胆道闭锁1例，其它原因7例。     

新生儿缺氧缺血性脑病脑干听觉诱发电位的观察

目的探讨新生儿缺氧缺血性脑病（ＨＩＥ）脑干听觉诱发电位（ＢＡＥＰ）的特点。方法对３９例ＨＩＥ患者的ＢＡＥＰ进行检测。结果ＢＡＥＰ异常率为８９．７４％，且ＨＩＥ的病情与ＢＡＥＰ的异常程度明显相关。提示ＨＩＥ时以脑干损害为主。结论检测ＢＡＥＰ能了解ＨＩＥ时脑组织损伤及其严重程度，且可作为评定ＨＩＥ预后的重要客观指标之一     

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、Ⅱ、Ⅱ、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（Ｐ〈０．０１），３ｈ后各植逐渐缩，提示ＢＡＥＰ可反映犬脑干缺血后的脑干损害，可客评     

BAEP在新生儿缺氧缺血性脑病诊断中的应用价值

目的应用脑干听觉诱发电位（BAEP）为诊断新生儿缺氧缺血性脑病（HIE）及分度提供科学诊断依据。方法采用丹迪CANTATA型肌电诱发仪对30例HIE惠儿进行监测和记录。结果BAEP正常4例（13．3％），异常26例（86．7％）。结论本研究BAEP检查敏感性高，影响因素小，结果准确可靠，对诊断HIE预测、评价预后和指导治疗均有一定的价值。     

脑干听觉诱发电位在血管性痴呆的应用价值

目的 探讨脑干听觉诱发电位(BAEP)在血管性痴呆患者应用价值.方法 选择200例血管性痴呆患者进行脑干听觉诱发电位(BAEP)检测分析.结果 脑干听觉诱发电位显示研究组III、V波潜伏期(PL)和I～III、III～V、I～V波峰间潜伏期(IPL)及(III～V)/(I～III)比值均高于对照组,差异有统计学意义(P<0.01).结论 脑干听觉诱发电位可客观的反映听觉系统和脑干功能状况,预防疾病进一步发展,对血管性痴呆的临床诊疗及预后均有价值.     

脑干听觉诱发电位在小脑卒中应用的价值探讨

对２８例小脑卒中患者进行脑干听觉诱发电位（Ｂｒａｉｎｓｔｅｒｎａｕｄｉｔｏｒｙｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ，ＢＡＥＰ）检测研究，其中小脑出血１９例，小脑梗塞９例，结果发现：ＢＡＥＰ在小脑卒中的异常为８５．７１％，且主要发生在病灶侧，部分病例可累及双侧。主要以Ⅲ，Ⅴ波ＰＬ及Ｉ～Ⅲ，Ｉ～ⅤＩＰＬ延长，ＢＡＥＰ在出血及梗塞的定性上无参考价值，随着病情的好转，ＢＥＡＰ亦逐渐恢复正常。     

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,对早发现谢危新生儿的听力和脑干损害,尽早治疗有重要意义。     

脑干听觉诱发电位在不典型脑干梗死患者中的应用价值

目的探讨脑干听觉诱发电位(BAEP)在不典型脑干梗死患者中的特点及临床价值。方法使用肌电图诱发电位仪对86例不典型脑干梗死患者进行BAEP检查且与其MRI、CT结果比较。结果 86例不典型脑干梗死患者的BA-EP42例异常,异常率48.8%。MRI、CT无1例异常(P<0.01)。结论 BAEP能够间接评估不典型脑干梗死患者的供血情况,给临床诊断与治疗提供客观依据。     

急性脑血管病患者脑干听觉诱发电位研究

目的：研究急性脑血管病患者脑干听觉诱发电位（ＢＡＥＰ）变化。方法２４３例发病７例内的急性脑血管病患者和１２２例正常人进行ＢＡＥＰ检查。结果急性脑血管病患者ＢＡＥＰ异常率为８５．６％，明显高于正常对照组２５．４％，Ｐ〈０．０１。病情严重患者ＢＡＥＰ异常率为１００％，而轻，中型患者分别为７９．２％和８３．７％，与严重患者比较，Ｐ〈０．０１，ＢＡＥＰ异常主要表现为主波潜伏期和波间期延长，主波消失或分化不     

脑干听觉诱发电位在新生儿黄疸患儿中的应用

目的通过脑干听觉诱发电位(BAEP)检测,研究血清胆红素水平对新生儿黄疸患儿听力及脑干功能影响,及早产与足月黄疸患儿BAEP变化。方法297例新生儿黄疸患儿按血清胆红素(SB)水平分为5组,比较各组新生儿BAEP异常率。297例新生儿黄疸患儿按足月与早产分为2组,比较2组新生儿BAEP异常率。结果各组患儿BAEP异常率随血清胆红素水平增高而增高(P<0.01),早产儿BAEP异常率显著高于足月儿(P<0.01)。结论新生儿黄疸患儿血清胆红素水平越高,对BAEP影响越大,血清胆红素对早产儿影响更大。对新生儿进行BAEP检测,能及早发现听力及脑干功能异常,有利于早期干预。     

瞬目反射及脑干听觉诱发电位对脑干梗死疗效的评价

目的探讨瞬目反射和脑干听觉诱发电位对脑干梗死患者疗效的评价作用。方法40例经临床症状、体征定位于脑干髓内并经头部MRI检查明确诊断的脑干梗死患者(脑桥梗死31例、中脑梗死4例和延髓梗死5例),分别计算治疗前后瞬目反射各成分的平均潜伏期;观察脑干听觉诱发电位波形及各波潜伏期、峰间期的变化。结果经治疗后40例患者临床症状及体征均有不同程度改善,治疗前后瞬目反射各成分平均潜伏期之间差异无统计学意义(P>0.05);3例脑桥梗死患者R1波恢复正常,临床基本痊愈。治疗前后脑干听觉诱发电位各波潜伏期及峰间期比较,差异亦无统计学意义(P>0.05);治疗后中脑梗死及脑桥梗死患者各有2例恢复正常,临床症状明显好转。结论瞬目反射与脑干听觉诱发电位均能敏感地反映脑干功能的变化,与临床表现具有一致性,但在发病15d内大部分病例的电生理活动不能恢复正常。     

新生儿缺氧缺血性脑病临床与神经病理研究

目的研究新生儿缺氧缺血性脑病(HIE)的临床特点和神经病理改变。方法回顾性分析52例死亡HIE患儿的临床特点,目视和光镜观察脑组织病理变化。结果所有患儿均为异常分娩,宫内窘迫占53．8％,产时窒息占38．5％,足月儿多发．占60％．临床表现多样,惊厥发生率高达75％,且多在生后48h之内发生。88％脑组织重量增加,25％超过正常均值加一个标准差,12％低于正常均值;均有不同程度脑水肿,神经细胞肿胀、变性及坏死,部分伴有颅内出血及软化灶形成;脑缺氧缺血易感区与胎龄有关,足月儿以皮质层状坏死为主,早产儿多为室管膜下-脑室内出血;宫内窘迫的足月小样儿脑损害程度更重;蛛网膜下腔出血(SAH)发生率高达63％,且以渗出性出血为主。结论研究HIE的临床与神经病理联系有助于揭示HIE发病机制及指导治疗。     

电刺激诱发瞬目反射和脑干听觉诱发电位在多发性硬化诊断中的作用

目的　探讨瞬目反射 (BR)在多发性硬化 (MS)诊断中的价值。方法　对 32例确诊MS患者分别进行BR和脑干听觉诱发电位 (BAEP)检测。结果　MS组BR检测在有脑干症状组和无脑干症状组的脑干损害检出率分别为 85 7%和 5 0 0 % ;BR检测对MS组患者Ⅴ、Ⅶ脑神经损害的异常检出率均为 2 1 9% ;BAEP检测在有脑干症状组和无脑干症状组的脑干损害检出率分别为 71 4 %和4 4 4 % ;BR、BAEP及二者联合检测检出MS患者脑干损害的阳性率分别为 6 5 6 %、5 6 3%和75 0 %。结论　BR能检出MS患者脑干、三叉神经及面神经的亚临床病灶 ;BR与BAEP联合检测更易于发现脑干亚临床病灶 ,有助于MS的早期诊断     

阿尔茨海默病患者脑电图和多项脑诱发电位的变化研究

目的探讨阿尔茨海默病患者自发和诱发脑电特征。方法应用脑电图和多项脑诱发电位检测方法对26例阿尔茨海默病患者及15名正常对照者进行脑电图(EEG)、脑干听觉诱发电位(BAEP)、视觉诱发电位(VEP)和P300等检测。结果(1)轻度阿尔茨海默病患者的EEG异常率及异常者的EEG表现与对照组基本一致;但随着阿尔茨海默病程度的加重,EEG异常率及异常者的EEG表现与对照组间相比,差异具有显著性意义(P<0.01);(2)与对照组相比,中、重度阿尔茨海默病患者的BAEPⅢ波和Ⅴ波绝对波潜伏期延长及绝对波幅降低,VEP的P200波潜伏期明显延长,差异具有显著性意义(P<0.05或P<0.01);(3)与对照组相比,阿尔茨海默病患者的P300潜伏期明显延长(P<0.05或P<0.01),且轻、中、重度患者间差异亦有显著性意义(P<0.05)。结论脑电图和多项脑诱发电位相结合的检测方法能较为客观地反映阿尔茨海默病患者的脑功能状态,有可能作为阿尔茨海默病辅助的脑电生理诊断方法,也是近年来提出病因假说的间接佐证。     

轻度认知损害老年患者脑干听觉反应、P300及脑电图的研究

目的 探讨轻度认知损害(MCI)患者的脑干听觉反应(BAEP)、事件相关电位(ERP)P300和脑电图(EEG)的特点,为早期痴呆的诊断提供帮助。方法 对38例MCI患者(MCI组)、26例阿尔茨海默病(AD)患者(AD组)进行BAEP和P300、EEC检查,并与20名健康老年人(健康组)作比较。结果 BAEP检查:MCI组与AD组左侧Ⅰ、Ⅱ波的差异均有显著性,P<0.05;MCI组与健康组比较,左、右侧Ⅳ、Ⅴ波的差异有显著性,P<0.05;AD组与健康组比较,左侧Ⅰ-Ⅳ波及右侧Ⅳ、Ⅴ波的差异均有非常显著性(P<0.01),右侧Ⅰ波差异有显著性(P<0.05)。P300检查,MCI组与AD组只在潜伏期的Pz点差异有显著性(P<0.05);MCI组与健康组在潜伏期Cz点差异有显著性(P<0.05);AD组与健康组比较,潜伏期的Fz、Cz、Pz点差异均有非常显著性(P<0.01),波幅的Cz点差异有显著性(P<0.05)。EEG显示,MCI组未见明显异常的18例,轻度异常17例,中度异常3例;AD组未见明显异常的1例,轻度异常8例,轻-中度异常9例,中度异常8例。结论 P300潜伏期的Pz点的改变可能有助于区分MCI和AD,而右侧Ⅳ、Ⅴ波的延长提示MCI患者可能有早期痴呆;EEG左侧颞部θ波增多提示MCI患者可能有早期AD。     

Influence of magnetic resonance imaging on somatosensory and brain-stem auditory evoked potentials in man

Summary There is still a need to prove that even static magnetic fields up to 1.5 T used in magnetic resonance imaging (MRI) are biologically safe and harmless for humans. Recordings of median and ulnar nerves and brain-stem auditory evoked potentials in 20 patients were completed prior to and after MRI investigation of the central nervous system. Neither the somatosensory nor the auditory evoked potentials exhibited any significant change of latencies, interpeak latencies or amplitudes. Since these electrophysiological parameters are highly dependent on the quality of nerve conduction and integrity of information processing in various nuclei, it may be assumed that MRI causes no lasting changes in either respect.     

Changes in auditory P300 event-related potentials and brainstem evoked potentials in diabetes mellitus

To investigate the influence of diabetes mellitus on higher cognitive functions electrophysiologically, we studied auditory P300 event-related potentials (P300) in 40 NIDDM patients, taking into account wave I-V latencies (I-V) in auditory brainstem evoked potentials, clinical parameters and head MRI findings. Compared with 20 controls, diabetics had significantly longer P300 and I-V latencies. P300 latencies in diabetics correlated with neither I-V. HbA₁, blood glucose levels, nor disease duration. Of the 13 diabetics investigated neuroradiologically, four had lacunar infarcts with prolonged electrophysiological values. The remaining nine had normal MRI scans, but their physiological parameters were still significantly longer than those of controls. These findings suggest that NIDDM can independently alter higher cognitive and the central auditory pathway functions. Our data also suggest that these alterations occur regardless of the recent metabolic derangement and disease duration. Cerebrovascular ischemia, if present, also appears to contribute in part to cognitive alterations.     

Effects of carbamazepine and valproate on brainstem auditory evoked potentials in epileptic children

Brainstem auditory evoked potentials (BAEPs) were recorded in 18 epileptic children receiving carbamazepine and 10 epileptic children receiving valproate. BAEPs were recorded before the administration of antiepileptic drugs (AEDs) and 13 months later during which the children received AEDs. Statistical analysis of peak latencies and interpeak intervals of waves I–III–V were made. Carbamazepine treatment resulted in prolongation of peak latencies of waves I–III–V and interpeak intervals I–III and I–V. Valproate monotherapy, on the other hand, caused no consistent changes on BAEP. On the basis of these results we suggest that chronic carbamazepine therapy exerts a suppressive influence on the auditory pathways, both peripherally at the level of the cochlea and/or auditory nerve, and centrally at the brainstem.     

Auditory evoked potentials recorded intracranially from the brain stem in man

Auditory evoked potentials were recorded in patients undergoing neurosurgical operations to manage cranial nerve dysfunctions. Recordings were made intra-operatively from the distal portion of the eighth nerve, from the entrance of the eighth nerve into the brain stem, and from a site overlying the superior olivary complex (rostral and medial to the entrance of the eighth nerve). The potentials at the three different loci showed characteristic differences: the responses recorded at the entrance of the eighth nerve into the brain stem showed three peaks about 1 ms apart. The earliest peaks had longer latencies than did those recorded at a distal locus on the eighth nerve, which is consistent with what we know about propagation of nerve impulses in the auditory nerve. The responses recorded on the brain stem, rostral-medial to the eighth nerve, also showed three peaks but the amplitude of the third peak was greater than those of the other two. It is assumed that the first peak originates in the auditory nerve, the second peak in the cochlear nucleus, and the third peak in the lateral superior olive. The latencies of these peaks match the latencies of peaks II, III, and IV of scalp-recorded brain stem evoked potentials.