MEP、NCV、FW在突眼性甲状腺肿中的应用

目的:了解突眼性甲状腺肿患者感觉传入神经以及运动传出通路(包括运动中枢、脊髓、神经根和远、近端周围神经)的功能状态。方法:对44例突眼性甲状腺肿患者采用表面电极法常规顺向检测正中神经和胫后神经共88条神经感觉传导速度(SCV)、运动末端潜伏期(DL)及波幅,F波(FW)潜伏期及出现率。并在88条尺神经和腓总神经从中枢至外周传出通路不同部位予以磁刺激,分别在小指展肌和胫前肌记录复合肌肉动作电位,分别测定各段潜伏期和中枢运动传导时间(CMCT)。结果:88条正中神经和胫后神经中有16条(18%)SCV减慢或波幅降低,12条(14%)ML延长或波幅降低。4条FW潜伏期延长,4条FW出现率降低。88条尺神经和腓总神经运动诱发电位(MEP)检查中有34条(39%)波幅降低,各节段潜伏期和CMCT均未见异常。结论:NCV、FW、MEP联合检测对判断突眼性甲状腺肿是否合并神经病变具有较重要作用。

Application of MEP, NCV, FW detection in patients with Graves disease

Objective:To investigate the nerve functional state in descending motor and sensory pathways in patients with Graves disease.Methods:The surface electrodes stimulation and recording were used for nerve conduction studies in 44 patients with Graves disease.The sensory conduction velocity(SCV)and the motor distal latency(DL)were detected in 88 nerves including median nerves and posterior tibial nerves.The occurrence rate and the latency of F-wave(FW)were obtained.Magnetic stimulation motor evoked potential(MEP)of the brain,spinal cord,roots and periphery nerves were recorded in 88 nerves including ulnar and peroneal nerves.Results:bnormalities were noted in 12(14%)of 88 motor nerves and in 16(18%)of 88 sensory nerves.The latencies of FW was prolonged and the occurrence rate of FW decreased in 8(9%)of 88 motor nerves.MEP studies demonstrated decrease of the amplitude of CMAP in 34(39%)of 88 motor nerves.Meanwhile,the polyphasic,short duration and low amplitude of MUAP were showed in 58(66%)muscles.The results of NCV,FW,MEP and the date of clinic demonstrated the dysfunction of muscles and the lesion of nerves in the patients with Graves disease.Conclusions:NCV,FW,MEP and EMG are very helpful in diagnosis of Graves disease associated with lesion of nerves and muscles.It can be used to objectively evaluate the effect of management.