神经电生理在儿童Miller-Fisher综合征中的特征

发布时间：2018-03-27 14:39

本文选题：Miller-Fisher综合征　切入点：H反射　出处：《临床儿科杂志》2017年01期

【摘要】：目的探讨儿童Miller-Fisher综合征(Miller-Fisher syndrome,MFS)中神经电生理特征。方法选取34例MFS患儿,分别进行常规运动感觉神经传导检查,比目鱼肌H反射以及正中神经和胫神经F波检查。选择同期同年龄健康儿童33例为健康对照组,同年龄典型吉兰巴雷综合征(Guillain-Barre syndrome,GBS)患儿30例为GBS对照组,与MFS患儿进行对比。结果在MFS患儿中,常规运动神经传导速度和波幅,感觉神经传导速度均在正常范围,12例(35.29%)感觉神经电位波幅(SNAP)降低,5例(14.71%)有腓肠神经SNAP保留现象(即正中神经或尺神经SNAP波幅下降程度大于腓肠神经SNAP下降程度),22例(64.71%)H反射异常,12例(35.29%)SNAP下降。与健康对照组比较,MFS患儿感觉神经传导速度、腓肠神经SNAP的差异均无统计学意义(P0.05);但MFS患儿正中神经、尺神经SNAP明显下降,差异均有统计学意义(P均0.05)。与GBS对照组比较,MFS患儿的运动感觉传导波幅均较高、速度较快,差异均有统计学意义(P均0.01)。结论在MFS对照患儿中,可以见到末端感觉神经传导波幅降低,但SNAP影响有限,H反射异常是MFS最常见神经电生理异常。
[Abstract]:Objective to investigate the electrophysiological characteristics of children with Miller-Fisher syndrome (Miller-Fisher syndromes). Methods 34 children with MFS were examined by routine motor sensory nerve conduction. H-reflex of soleus muscle and F-wave of median nerve and tibial nerve were examined. 33 healthy children of the same age were selected as healthy control group, and 30 children with typical Guillain-Barre syndrome of the same age as GBS control group. Results routine motor nerve conduction velocity and amplitude were compared with those in children with MFS. Sensory nerve conduction velocities in 12 cases (35.29%) sensory nerve potential amplitude (SNAP) decreased in 5 cases (14.71%) there was SNAP retention in sural nerve (that is, the decrease of SNAP amplitude of median nerve or ulnar nerve was greater than that of sural nerve SNAP. There were 12 cases with abnormal reflex in 64.71 cases with decreased SNAP. Compared with the healthy control group, the sensory nerve conduction velocity of MFS children was decreased. There was no significant difference in SNAP of sural nerve (P 0.05), but the SNAP of median nerve and ulnar nerve decreased significantly in children with MFS, and the difference was statistically significant (P < 0.05). Compared with the control group, the amplitude of motor sensory conduction was higher and the velocity was faster in children with MFS. Conclusion the amplitude of terminal sensory nerve conduction can be decreased in children with MFS, but SNAP has limited effect on H reflex abnormality, which is the most common electrophysiological abnormality in MFS.
【作者单位】：武汉市妇女儿童医疗保健中心神经电生理室;
【分类号】：R745.43

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