脑干三叉神经诱发电位对三叉神经根部分切断术的临床应用研究

目的 评价脑干三叉神经诱发电位对三叉神经痛病人三叉神经根切断术的临床应用价值.方法 作者研究了36例经术前MRTA及术中探查除外神经血管接触的三叉神经痛病人,在三叉神经感觉根大部切断术过程中,通过术前、中、后记录BTEP以监测三叉神经传导功能;测定BTEP潜伏期及波幅参量的变化指导手术的进程.结果 36例病人患侧BTEP潜伏期延长、波幅降低,提示三叉神经痛患者三叉神经传导功能损害,术中待BTEP呈一直线后,不再继续切断神经根,术后疼痛均缓解,未遗三叉运动功能障碍.结论 脑干三叉神经诱发电位可以指导选择性三叉神经根切断术并防止三叉神经眼支损害的发生.

Application study with brain-stem trigeminal evoked potentials on patients received partial sensory trigeminal rhizotomy

Objective To evaluate application value of brain-stem trigeminal evoked potentials in patients with trigeminal neuralgia received posterior root resection. Methods Thirty-six patients with primary trigeminal neuralgia excluding neuron-vascular contact and other compression factors by MRTA pre-operation and exploration at operation were examined by brain-stem trigeminal evoked potentials. BTEPs were monitored during both intra-operation and post-operation to examine trigeminal conduction function according to changes of latency and amplitude of BTEPs; therefore, to guide extent of incision of fibers of trigeminal nerve root. Results Latency delayed and amplitude decreased were seen in 36 patients with trigeminal neuralgia which indicates trigeminal nerve conduction of thirty-six patients with primary trigeminal neuralgia was damaged pre-operation and post-operation. While BTEP becomes a line resection of trigeminal nerve root was stopped. All thirty-six patients were free of pain without damages of ocular branch. Conclusion Successively monitoring of BTEPs may be an effective method to conduct selective partial sensory trigeminal rhizotomy (PSR) and avoid impairment of ocular branch of trigeminal nerve.