腓总神经腓骨小头处病变患者的神经电生理定位诊断

目的 探讨神经电生理检查对腓总神经腓骨小头处损害患者的定位诊断价值.方法 应用常规的神经电生理检测法:腓总神经运动传导、腓浅神经感觉神经传导、腓总神经支配肌肉的肌电图；特殊检测法:短节段性神经传导检测法,共检测了30例经临床诊断并进一步做神经电生理检查以确诊腓总神经腓骨小头处病变的患者.短节段性神经传导检测法重点检测腓总神经运动传导腓骨小头下、腓骨小头上,以寻找其具体损害部位.结果 ①腓总神经病变组中有28例出现腓总神经在腓骨小头下至腓骨小头上段运动神经传导速度减慢;②腓总神经腓骨小头下段至腓骨小头上段短节段性神经传导检测结果显示具体病变部位多数集中在腓骨小头上下2 -6 cm内;③腓总神经在腓骨小头处病变者并非均有胫骨前肌、踇长伸肌肌电图的异常.结论 短节段性神经传导检测法在确定腓总神经在腓骨小头处的具体损害部位时有较高的定位诊断价值,而常规的腓浅神经感觉传导及肌电图异常能协助诊断.

Neural electrophysiological localization diagnosis on patients with common peroneal nerve injury in capitulum fibulae

Objective To discuss the neural electrophysiological localization diagnosis on patients with common peroneal nerve injury in capitulum fibulae. Methods The conventional neural electrophysiological method： MNCV of common peroneal nerve, SNCV of superficial peroneal nerve, EMG of the muscles controlled by common peroneal nerve. Special method： short segment stimulation method; to detect the clinically diagnosed 30 patient with common peroneal nerve injury in capitulum fibulae.The method of short segment stimulation emphasize on both MNCV of superior and inferior part of capitulum fibulae to look for specific site of the injury. Results ①The 28 patients with the injury of common Deronealnerve showed reduction in MNCV of common peroneal nerve fi＇om inferior to superior part of the capitulum fibulae. ②Short segment stimulation method of common peroneal nerve from inferior to superior part of the capitulum fibulae showed the most specific site of the lesion were ranged 2 - 6 c,n between superior and inferior part of the capitulum fibulae. ③Patients with common peroneal nerve injury in capitulum fibulae not all involve the EMG abnormity in anterior tibial muscle and extensor digitorum longus. Conclusions Short segment stimulation method shows higher localization diagnostic value in patients with common peroneal nerve injury in capitulum fibulae and conventional abnormity in SNCV of superficial peroneal nerve and EMG is helpful in diagnosis.