脊髓疾病体感诱发电位检测的临床应用

目的　探讨体感诱发电位 (SEP)在脊髓病变中的诊断价值。方法　采用丹麦Keypoint肌电 /诱发电位仪 ,对 66例脊髓病变者进行SEP检测。 66例均行下肢胫后神经SEP(SEPt)检测 ,其中 2 8例同时行上肢正中神经SEP(SEPm)检测。结果　SEPt检测 66例中 64例异常 (96 .9% ) ,SEPm检测 2 8例中 1 7例异常 (60 .7% ) ,SEPt检测结果异常率明显高于SEPm。异常表现均以波幅降低为主 ,SEPt异常以波幅降低为主者占 73 .5 % ,SEPm异常以波幅降低为主者占 88.2 %。结论　SEP反映了躯体感觉传导通路、脑干网状结构及大脑皮层的功能状态。脊髓病变SEPt检测敏感性明显大于SEPm ,异常表现以电位波幅降低为主。因此 ,SEP不仅对脊髓病变的定位诊断有参考价值 ,而且对判断脊髓损伤程度、评估疗效及脊髓功能状态均有重要指导意义

The clinical apply of somatosensory evoked potential examination in spinal cord diseases

Objectives To study the diagnostic values of somatosensory evoked potential (SEP) in spinal cord diseases. Methods SEP was performed in 66 patients with spinal cord disease. The tibial nerve of the pelvic limb of SEP (SEPt) was performed in all of the 66 patients, and the median nerve of the thoracic limb of SEP (SEPm) was performed in 28 of the 66 patients.Results The abnormality of SEPt was found in 64 ones of 66 patients (96.9%), and the abnormality of SEPm in 17 ones of 28 patients (60.7%). The abnormality rate of SEPt was higher than one of SEPm.The abnormality of SEPt and SEPm mainly showed the decrease of amplitude. The rate of the decrease of amplitude in SEPt and SEPm was 73.5% and 88.2%.Conclusions Somatosensory conduction way, the reticular of brainstem and the state of cerebral cortex function was reflected by SEP. The sensitivity of SEPt was higher one of SEPm in the spinal cord diseases. Therefore, not only the SEP had the reference value in topical diagnosis of spinal cord diseases, but important guiding curative effect, and the state of spinal cord function.