应用感觉神经电位和体感诱发电位诊断臂丛损伤

作者根据感觉神经电位(Sensory nerve action potential,以下简称SNAP)和体感诱发电位(Somatosensory evoked potential,以下简称SEP)改变,对30例臂丛神经损伤作定位诊断。电生理诊断和手术结果完全与基本符合者共25例,占83.3％。作者提出应注意臂丛节前损伤可伴有双重嵌压致SNAP消失而造成误诊。讨论了电生理诊断准确率上干低于中、下干的原因。建议除桡浅神经外检测正中神经(拇指),以利于对C_6神经根损伤的准确定位。

ASSESSMENT OF BRACHIAL PLEXUS INJURIES BY SENSORY NERVE ACTION POTENTIALS AND SOMATOSENSORY EVOKED POTENTIALS

Thirty cases with braehial ploxus injuries were assessed by changes in the sensory nerve action potentials (SNAP) and somatosensory evoked potentials (SEP). The results were checked against definite surgical diagnoses. The electro-physiological diagnoses were found to be entirely or essentially in accord with the surgical findings in 25 cases (83.3%). However , the preganglionic lesions of the brachial plexus may be accompanied by double crush, thus rendering SNAP undetectable, which may, in turn, lead to misdiagnosis. Factors which caus electrophysiological diagnosis less accurate in the upper trunk than in the middle and lower trunks are discussed. We suggest testing of SNAP and SEP of the median nerve (the thumb) in addition to those of the superficial radial nerve, which will facilitate more accurate localization of lesions in the Oa nerve root.