神经电生理检测对多灶性运动神经病诊断价值的初步研究

目的 探讨神经电生理检查在多灶性运动神经病(MMN)中的诊断价值。方法对16例MMN患者及16名健康对照进行运动神经传导速度和感觉神经传导速度检查，记录刺激引出的复合肌肉动作电位的波幅、波宽、面积、位相和时限，进行对比分析，判定是否有运动神经传导阻滞(CB)或暂时性离散(TD)，并有选择性地进行常规肌电图检查。结果16例患者均可见有一根以上运动神经或至少一根运动神经的一个以上部位出现CB或CD。其中13例双上肢正中神经，尺神经出现CB，3例以正中神经、尺神经的远端出现CB首发，随病情进展出现下肢腓深神经CB。仅有2例感觉神经传导速度稍有减慢，波幅略有降低。16例患者神经受累区域以下所支配肌肉肌电图检查见有神经源性损害。结论MMN是一种以远端神经受累为主的不对称性周围神经病，神经电生理检查对诊断和鉴别诊断．MMN起重要作用，CB是MMN的主要神经电生理表现。

Preliminary research on electroneurophysiological examination for diagnosis of multifocal motorneuropathy

Objective To explore the diagnostic value of electroneurophysiology for multifocal motorneuropathy (MMN). Methods Two groups, MMN sufferers and the normals, each containing 16 cases, were examined for motor conduction velocity (MCV) and sensory conduction velocity (SCV). The amplitude, width, area, phase and duration of compound muscle action potentials (CMAP) induced by electric stimulation were recorded and analyzed and the results were compared, then the conduction block (CB) of motor nerve or temporary dispersion (TD) were determined. Results CB and TD emerged in more than one motor nerve or more than one site of a motor nerve in 16 MMN cases. CB was shown in both of the upper limbs of 13 MMN cases, and the other 3 cases showed CB in the distal part of median nerves and ulnar nerves firstly, and then in deep peroneal nerves with a development of the conditions. In only two MMN cases, SCV got slow and the amplitude decreased slightly. EMG showed neurotic damages in the muscles dominated by the affected nerves. Conclusion MMN is a unsymmetrical peripheral neuropathy which was affected mainly on the distal part of the nerve. Electroneurophysiology plays an important role in the diagnosis and discrimination of MMN. CB might serve as a characteristic of MMN.