帕金森病患者VEP、BAEP及SEP的测定

目的：研究帕金森病（PD）患者视觉诱发电位（VEP）、脑干听觉诱发电位（BAEP）及体感诱发电位（SEP）的变化并推测其发生机制。方法：选择2008年1月至2013年1月在昆明医学院第一附属医院神经内科门诊及住院的80例PD患者作为PD组,50例健康对照者作为对照组。应用神经电生理检查仪分别对PD患者和健康者进行VEP、BAEP和SEP检测,并进行比较。结果：PD组VEP的P100潜伏期（115．1±10．6）ms较健康对照组（103．2±9．0）ms明显延长（P〈0．01）,P100波幅（6．25±3．02）弘V较健康对照组（7．70±2．62）pV增高（P〈0．05）;PD组BAEP的I、Ⅱ、Ⅲ波的潜伏期和Ⅲ-V及I—V峰间期较对照组明显延长（P〈0．05）;SEP各波潜伏期及波幅两组比较差异无显著意义。结论：PD患者的VEP和BAEP均有不同程度的改变,提示PD患者可能伴有脑干听觉传导通路与视觉俜导诵略的桶害．     

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.     

The usefulness of the brainstem auditory evoked potential in the early diagnosis of cranial nerve neuropathy associated with diabetes mellitus

BACKGROUND: An evaluation of the extent and mechanism of damage of the central nervous system in diabetes mellitus is of high value in current neurological research. Electrophysiological abnormalities are frequently present is completely asymatomatic diabetes mellitus (DM) patients. Limited data is available in the use of brainstem auditory evoked potential (BAEP) in DM. AIM: Is to evaluate the efficacy of BAEP as a method useful in the diagnosis of subclinical damage of the central nervous system in DM. MATERIAL AND METHOD: 67 diabetes and 32 healthy controls - age and sex matched - were chosen. The diabetes were of type I and II and more than or less than 10 years duration. The BAEP was elicited by using auditory stimulus by using Dantec Evomatic 4000 evoked potential machine. The latency of component response recored as waves I, III and V, interpeak latency (IPLs) I - III, I - V, III - V and amplitude of waves V. RESULTS: The difference was highly significant in the increased latency of waves I, III and V, interpeak latency (IPLs) I - III, I - V, III - V and amplitude of waves V of each type of diabetes as compared to control. Comparison of the type and duration of diabetes between each other showed no significant difference. CONCLUSION: BAEP recording can represent an objective, clinically useful and non invasive procedure to stress the early impairment both of the auditory nerve and of brainstem function.     

P300等诱发电位对亚临床肝性脑病早期诊断的意义

目的:观察事件相关电位P_(300)、体感诱发电位、视觉诱发电位和脑干听觉诱发电位在亚临床肝性脑病诊断中的意义。方法:50例亚临床肝性脑病患者进行了心理测验,并做了头颅CT和视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位检查,30例正常人做为对照组。结果:亚临床肝性脑病的心理测验,韦氏法智力低下率为76％,视觉诱发电位异常率为13％,脑干听觉诱发电位异常率为20％,体感诱发电位异常率为40％,事件相关电位异常率为71％,正常对照组四种诱发电位的正常率是100％。头颅CT结果与亚临床肝性脑病无关。结论:视觉诱发电位、体感诱发电位、脑干听觉诱发电位和事件相关电位在亚临床肝性脑病中是异常的。事件相关电位更为敏感,对亚临床肝性脑病的早期诊断有重要意义。     

高热惊厥脑干听觉诱发电位的分析

本文报道了30例高热惊厥患儿的脑干听觉诱发电位检测结果。结果提示,高热惊厥患儿脑干听觉诱发电位异常率较高,以Ⅰ—Ⅴ波峰间期延长为主,同时Ⅰ、Ⅲ、Ⅴ波耳间差值增大。文中讨论了这一结果与高热惊厥发病年龄特征的关系。     

诱发电位对痴呆和非痴呆型帕金森病与宾斯旺格病的比较研究

目的 :探讨帕金森病 (PD)与宾斯旺格病 (BD)患者的中枢神经通路和认知功能状态。方法 :对无痴呆的PD 2 8例 (PD组 ) ,伴痴呆的PD 2 2例 (DPD组 )及BD组 18例进行①体感诱发电位 (SEP)、②视觉诱发电位 (VEP)、③脑干听觉诱发电位 (BAEP)和④事件相关电位 (ERP)检查。结果 :①SEP :PD组中 5例 (18% )异常 ,DPD组中 8例 (36 % )异常 ,BD组中 11例 (6 1% )异常 ;②VEP :PD组仅 1例 (4% )异常 ,DPD组中 4例 (18% )异常 ,BD组 3例 (17% )异常 ,经统计学处理 ,潜伏期与左右眼差值均无显著差异 ;③BAEP :PD组中 4例 (14% )异常 ,DPD组中 5例异常 (2 3% )异常 ,BD组 4例 (2 2 % )异常 ;④ERP :PD组中 5例异常 (18% ) ,DPD组 9例异常 (41% ) ,BD组 11例异常 (6 1% )。结论 :SEP和ERP阳性率最高 ,其阳性率的顺序为BD >DPD >PD ,提示三组病例的中枢神经系统功能的损害有明显区别。     

100例突聋患者的脑干听觉诱发电位观察

目的:观察BAEP在突聋患者中的变化规律,探讨其应用价值。方法:对突聋组患者结合正常对照,进行BAEP分析。结果:突聋患者,BAEP各波潜伏期、I—V峰间期、Ⅲ-Ⅴ/Ⅰ-Ⅲ比值明显长于正常人(PM相似文献   

多发性硬化患者的视觉、听觉和体感诱发电位的诊断价值

目的:探讨视觉诱发电位(VEP)、听觉诱发电位(BAEP)、体感诱发电位(SEP)对多发性硬化(MS)的诊断价值。方法:对22例临床诊断为MS的患者进行VEP、BAEP、SEP检测,并与正常对照组进行比较分析。结果:22例MS患者中VEP异常15例(68.2%),BAEP异常9例(40.9%),SEP异常12例(54.5%),异常中VEP有53.3%、BAEP有44.4%、SEP有58.3%的患者,临床有相应症状。结论:VEP、BAEP、SEP的检测有助于MS诊断以及亚临床病灶的发现。     

Evaluation of asymptomatic central neuropathy in type I diabetes mellitus

OBJECTIVES: Diabetic neuropathy is recognized as the most common clinical picture of nervous system disorders caused by diabetes mellitus (DM). Although peripheral and autonomic nervous system involvements are frequently encountered, there exists a few data about the incidence of central diabetic neuropathies. Central nervous system degeneration is a well known pathology in diabetic patients in the long term. It is possible to reveal central nervous system involvement at the early stages by using evoked potentials (EP). The aim of this study is to evaluate the auditory, visual and sensorial abnormalities in type I diabetic patients, who also have normal nerve conduction studies, with somatosensory, brainstem auditory and visual EP studies (SEP, VEP BAEP); to determine the frequency of these abnormalities and to investigate the relationship between other variables such as age, gender, duration of the diabetes and degree of the metabolic control. PATIENTS AND METHODS: A total of 36 asymptomatic type I DM children, ages ranging between 6-17 (mean age 11 +/- 3.24) taking insulin treatments were included in this study. Control group was made up of healthy children. EPs were evaluated and comparisons were made between the two groups. RESULTS: In a large group of diabetic children (47.2%), independent from parameters such as age, gender, glycemic control degree, auditory and visual deficits, retinopathy, joint movement limitation; but dependent on the peripheral SEP pathologies and disease duration there were central electrophysiological disturbances. In 13 (36.1%) of the patients SEP pathologies; in 9 (25%) of the patients VEP pathologies and in 14 (38.9%) of the patients BAEP pathologies were detected. Conclusion: Besides independent from peripheral pathologies, central nervous system involvement could also be observed in diabetic children. EP changes can be detected in asymptomatic patients that would be a predictor of future symptoms.     

视觉、脑干听觉诱发电位对多发性硬化的诊断价值

目的 :探讨视觉诱发电位 (VEP)、听觉诱发电位 (BAEP)对多发性硬化 (MS)的诊断价值。方法 :对 30例临床诊断为MS的患者进行VEP、BAEP检测 ,并与正常对照组进行比较分析。结果 :MS患者VEP和BAEP的异常率分别为 73%和 6 0 %。异常中VEP有 6 8% ,BAEP有 78%的患者 ,临床有相应的症状 ;VEP 32 % ,BAEP 2 2 %的患者临床无相应症状。 5例MS患者在临床缓解期复查VEP、BAEP ,1例VEP、BAEP恢复正常 ,4例仍异常。结论 :VEP、BAEP检测对MS的诊断具有重要意义。     

后颅凹肿瘤术中的脑干听觉诱发电位监测分析

目的:探讨脑干听觉诱发电位技术对后颅凹肿瘤术中监护的临床意义。方法:对16例后颅凹肿瘤患者进行术前检查,术中监护,并对BAEP各波波形、潜伏期进行分析。结果:Ⅰ、Ⅲ、Ⅴ波潜伏期延长10例伴Ⅰ—Ⅲ、Ⅲ—Ⅴ或Ⅰ—Ⅴ波波间期延长;波形分化不良或波幅较低6例;手术操作牵拉可引起BAEP不同程度变化。结论:后颅凹占位病变术中的BAEP监护,对保护听觉和脑干功能及术后功能的评估有重要意义。     

阿尔茨海默病与脑血管病痴呆患者的诱发电位比较研究

目的：观察阿尔茨海默病痴呆（AD）和脑血管病痴呆（VD）视觉及听觉诱发电位的特点。方法：收集25例AD组、24例VD及22名正常老年人（NC），完成听觉诱发电位（AEP）和视觉诱发电位（VEP）检查，并进行简易智力状态检查（MMSE）评分比较。结果：与NC组相比，AD组AEP的N1、P2，VEP的P1潜伏期延迟，AEP的P2、P2，VEP的P2、P3波幅降低；VD组VEP的P2潜伏期延迟，P2和P3波幅降低。AD组和VD组相比，AD组AEP的N1、P2潜伏期延迟于VD组。AD组VEP的P2波的潜伏期，VD组AEP的P3波幅及VEP的N1潜伏期改变与其MMSE评分有关联。结论：AD组和VD组的诱发电位有类似变化，两组的VEP和AEP变化与MMSE相关。     

多种诱发电位和MRI检查在多发性硬化诊断中的价值

目的：探讨诱发电位和磁共振成像（MRI）检查在多发性硬化（MS）诊断中的价值。方法：收集65例MS患者的临床资料、磁刺激运动诱发电位（MEP）、脑干听觉诱发电位（BAEP）、视觉诱发电位（VEP）、体感诱发电位（SEP）以及MRI结果,比较不同检测方法对其临床诊断的价值。结果：MS患者的磁刺激MEP、BAEP、VEP、SEP以及MRI的异常检出率分别为78％（51／65）、51％（33／05）、80％（52／65）、71％（46／65）和85％（55／65）。4项诱发电位检查总异常检出率为88％（57／65）,与MRI检查结果比较差异无统计学意义（P〉0．05）。各种诱发电位和MRI检查均能发现临床下病灶：6例患者经MRI检查发现病灶但无相应临床症状;8例患者有临床症状而MRI检查未见相应病灶,但诱发电位检查可见异常。结论：MRI和各种诱发电位检查具有相互补充作用,结合临床合理选择使用此两种检查有助于提高MS诊断的敏感性。     

Multimodality evoked potentials and neurological phenomenology in patients with multiple sclerosis and potentially related conditions

A comparative study of evoked potential recordings and neurological phenomenology was performed in 151 patients. The material included 95 subjects with MS, myelopathy of unverifiable etiology or optic neuritis. Multimodality evoked potentials (VEP, BAEP, median and tibial nerve SEP) and clinical data were evaluated independently. The highest rates (86-98%) of evoked potential abnormalities were found in patients with MS (clinically definite or probable) and myelopathies. More than one pathological evoked potential modality occurred in 47-69% of these subjects. Tibial nerve SEP yielded the highest frequency of abnormalities. The occurrences of silent lesions and missed lesions (i.e. normal evoked potentials in spite of clinical manifestations) were investigated for the various evoked potential modalities. Silent lesions were detected in 50-68% of the MS and myelopathy patients; SEP and VEP exhibited similar abnormality rates for clinically unaffected pathways. Missed lesions most often occurred for BAEPs but were not uncommon for the other modalities. Further evaluation of the SEP data revealed significant differences of amplitudes between patients with missed lesion and controls.     

后颅凹肿瘤切除术前后脑干听觉诱发电位监测

目的 :研究脑干听觉诱发电位 (BAEP)在后颅凹肿瘤切除术前后的监测价值。方法 :对35例后颅凹肿瘤患者进行术前术后BAEP动态监测 ,并以 10 0名听力正常的健康受试者作对照。结果 :术后BAEP的变化和临床过程及预后是平行一致的 ;术前BAEP异常者术后早期多有V波潜伏期延长 ;术后 6～ 10天检测 ,术前异常者多有明显恢复 ;术后潜伏期的恢复较波幅的恢复明显。结论 :BAEP适用于后颅凹肿瘤切除术后监测 ;术后BAEP改变能反映脑干功能和预测预后。     

BRAIN DYSFUNCTION OF PATIENTS WITH QIGONG INDUCED MENTAL DISORDER REVEALED BY EVOKED POTENTIALS RECORDING

Objective: In order to investigate the brain function of patients with Qigong induced mental disorder (QIMD), this study was carried out. Methods: Four kinds of evoked potentials, including contingent negative variation ( CNV) , auditory evoked potentials ( AEP) , visual evoked potentials ( VEP), and so-matosensory evoked potentials (SEP), were recorded from 12 patients with Qigong induced mental disorder. Comparison of their evoked potentials with the data from some normal controls was made. Results: The results revealed that there were 3 kinds of abnormal changes in evoked potentials of patients with QIMD that is latency prolongation, amplitude increase and amplitude decrease, as compared with normal controls. Conclusion: Brain dysfunction of patients with QIMD was confirmed. Its biological mechanism needs further studying.     

127例轻型头部外伤脑干听觉诱发电位的分析

对127例轻型头部外伤患者的脑干听觉诱发电位(BAEP)的检测结果分析,发现BAEP异常70例(55％),主要表现为:Ⅰ—Ⅲ,Ⅰ—Ⅴ峰间期延长,Ⅴ波潜伏期延长,Ⅲ—Ⅴ/Ⅰ—Ⅲ>1。统计学处理有显著差异(P<0.05)。其中63例行颅脑CT检查,异常10例(16％)。随访9例,BAEP恢复正常3例,无变化6例,BAEP的恢复一般需10周时间。分析结果表明,轻型头部外伤患者,存在有脑功能的损伤,BAEP是评价脑功能损伤较敏感的客观指标。     

慢性肾功能不全患者的脑干听觉诱发电位分析

本文对54例慢性肾功能不全(CRF)患者的脑干听觉诱发电位(BAEP)检查结果进行分析。全部患者均有不同程度的贫血,血红蛋白平均为53g/L,非蛋白氮平均为25.44mmol/L,肌酐平均为510μmol/L。患者组BAEP有不同程度异常,主要表现为Ⅰ～Ⅴ各波潜伏期和Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期延长(P<0.05和<0.01),波幅降低,波形分化不清或消失。本病患者有神经系统损害,特别是脑干损害者尤为明显。应用BAEP对CRF患者并发尿毒症脑病的可进行早期诊断,脑干的电生理变化因体内毒性物质的有害影响而产生异常。     

Somatosensory amplification and its relationship to somatosensory, auditory, and visual evoked and event-related potentials (P300)

Somatosensory amplification refers to the tendency to experience benign and ambiguous somatic sensation as intense, noxious, and disturbing. The construct is helpful in assessing the perceptual style of a variety of somatizing conditions, but there is no human study clarifying the effects of neurological function on somatosensory amplification. The present study examines the relationship between somatosensory amplification and different types of evoked potentials. In 33 healthy volunteers (mean age 24 years, 18 men), latencies and amplitudes were recorded using the following parameters: short-latency somatosensory, brainstem-auditory, and visual evoked potentials (SSEP, BAEP, and VEP, respectively) and auditory event-related potentials (ERP). All subjects completed questionnaires for the Somatosensory Amplification Scale (SSAS), 20-item Toronto Alexithymia Scale (TAS-20), and Profile of Mood State (POMS). The SSAS scores were significantly associated with the P200 latency (p=0.020) and P300 amplitude of ERP (p=0.041), controlling for the significant effect of the TAS and POMS depression and tension-anxiety scales. The SSEP, BAEP, and VEP latencies or amplitudes were not statistically significant (all p>0.05). When the subjects were divided into high and low SSAS groups based on the median of the SSAS scores, the P300 amplitude of ERP significantly discriminated the two groups (p=0.023) by multiple logistic regression analysis. Although the findings should be viewed as preliminary because of the small sample size, somatosensory amplification appears to reflect some aspects of long-latency cognitive processing rather than short-latency interceptive sensitivity from the viewpoint of encephalography.     

急性脑梗死患者BAEP与脑血流量相关性研究

目的：探讨脑干听觉诱发电位与脑血流量在急性脑梗死病人中的相关性,方法：对１２０例急性脑梗死患者和８０例上常人进行脑干听觉诱发电位（ＢＡＥＰ）及脑血流量（ＣＢＦ）检测。结果：脑梗死患者ＲＡＥＰ和ＣＢＦ异常率分别为７７％和６８％,病情愈重异常愈明显．脑梗死患者ＢＡＥＰ异常表现为主波潜伏期和波间期均比正常对照组延长（Ｐ＜０．０５～０．０１）,且病情愈重延长明显,ＢＡＥＰ延长患者ＣＢＦ明显低于正常患者（Ｐ＜０．０５～０．０１）。结论：ＢＡＥＰ是初步评价脑梗死患者脑功能和ＣＢＦ的有效手段。