瞬目反射、面神经电图和面肌肌电图对面神经炎的诊断、治疗和预后的评估

目的 探讨瞬目反射(BR)和面神经电图(ENG)、面肌肌电图(EMG)对面神经炎的诊断、治疗和预后的价值.方法 53例面神经炎患者在发病后1周内首次进行BR检查以及ENG、EMG测定,发病后1,3,6个月重复上述检查.结果 首次检查患侧R1、R2及R2'缺如者23例,其余有30例患侧R1、R2及R2'与健侧相比潜伏期延长,差异有统计学意义(P＜0.01).异常率达91%.37例患侧面神经运动传导与健侧相比潜伏期延长、波幅降低,差异有统计学意义(P＜0.05),异常率为75%.23例患侧出现正锐波、纤颤电位,运动单位电位波幅降低,时限延长,多相渡增多,病理性干扰相.1个月后复查,上述检查完全恢复者26例.3个月后复查完全恢复者42例,6个月后复查完全恢复者51例,2例未恢复者1年后仍遗留有后遗症.结论 BR测定是诊断面神经炎的敏感指标.BR结合ENG、EMG检测能评估面神经炎的病情、疗效及预后.

Blink reflex, electroneurography and eletromyography assisting diagnosis, clinical management and prognosis in facial neuritis

Objective To study the value of blink reflex BR;, electroneurography （ENG） and eleetromyography （EMG） in diagnosis, clinical management and prognosis of facial neuritis. Methods BR,ENG and EMG were recorded from 53 patients with facial neuritis on three to seven days after onset. Results The first detection, the ipsilateral R1 , R2 and R2＇ waves were absent in 23 cases, but existed in the remaining 30 cases, the latency of R1, R2 and R2＇ were prolonged in ipsilateral side compared with that in the contralateral side and showed significant difference （P ~ 0.01）. The abnormal rate was 91 ~. The latent period prolonged and wave amplitude degraded in 37 cases of ipsilateral facial nerve compared with that in the contralateral side and the difference was significant （P〈0.05）. The abnormal rate was 75%. The 23 patients had positive sharp wave（PSW）, fibrillation potential and wave amplitude degraded,latitude prolonged, polyphasic wave increased in motor unit potential（MUP）. There were 26 patients,42 patients and 51 patients recovered completely after one month, three months and six months respectively. Only 2 patients had residual after one year of the onset. Conclusions BR can be used as a sensitive index for diagnosis of facial neuritis. The detection of BR, ENG and EMG can be used as index for pathogenic condition,therapeutic reaction and prognosis in facial neuritis.