视觉诱发电位在中枢神经系统感染中的应用

中枢神经系统感染是神经系统疾病中一大类疾病,诊断主要依靠腰椎穿刺,留取脑脊液培养确诊。因致病菌不同,故发病机制、病理生理基础不同,疾病急性期严重程度及预后不同,但都可导致多种并发症发生,如视觉损害、听觉损害、继发性癫痫、脑脓肿等。因病初症状不典型、诊断不及时、治疗不彻底最终导致中枢感染后的致残率及致死率居高不下。早期评估中枢神经系统感染相关预后情况,对于提高患者后期生活质量、减轻家庭负担有很大帮助。目前评估中枢感染患者神经系统预后情况主要依靠后期医疗保健科门诊随访智力、运动等发育情况,或者依靠影像学,如头颅磁共振、头颅CT观察结构等,又或者应用脑电图从电生理学角度分析疾病进展及预后情况。视觉障碍为中枢系统感染后的一类并发症,因视觉障碍发病率低不易被关注,导致发现失明时为时已晚。视觉诱发电位(visual evoked potential,VEP)是一种应用脑电图形成原理,从中提取出来的一种电生理学检查方法,比脑电图操作简便、易于分析;与影像学观察结构不同,视觉诱发电位从神经传导方面解释病变性质及类型。目前视觉诱发电位逐渐应用于评估中枢神经系统感染患者的视觉传导通路,进而推测整个神经系统发育和受累程度。本文主要通过阅读文献总结其在神经系统感染中应用,并探讨其预后评估价值。 

The application of visual evoked potential in the infection of central nervous system

The infection of the central nervous systems (CSF) is a kind of disease of nervous systems, the diagnose of which is mainly confirmed by cerebrospinal fluid's culture through lumbar puncture.Because of different pathogens, the pathogenesis, pathophysiology, severity of acute phase and prognosis are different, but each can lead to many complications, such as visual impairment, hearing impairment, secondary epilepsy, brain abscess and so on.Because early symptoms are not typical, the diagnosis is not timely, resulting in delaying treatment, so morbidity and mortality of central nervous's infection are high.Early assessment of prognosis is helpful to improving the life quality of patients, reducing the burden of the family.The current assessments of CNS infection mainly depends on health care including the development of intelligence and movement, or relies on imaging, such as magnetic resonance and CT, or the application of electrophysiological methods.Visual impairment is a kind of complications after central nervous infection.Because the incidence of visual impairment is not easy to find, it is too late to find until blindness.Visual evoked potential (visual evoked potential, VEP) is a kind of method extracting from electroencephalogram (EEG), which is easier to learn and to analyze than EEG.It is different from MRI or CT, which is dominant to find the lesion of the nervous system.The visual evoked potential is gradually applied to the infection of central nervous system, and to infer the development and integrity of nervous system.This paper mainly relies on reading literature and sums up the application in nervous system infection, and explores the value of its prognosis.