短潜伏期体感诱发电位在慢性炎性脱髓鞘性多发性神经根神经病中的诊断作用

发布时间：2018-06-14 18:36

本文选题：短潜伏期体感诱发电位 + 慢性炎性脱髓鞘性多发性神经根神经病　；参考：《中国当代儿科杂志》2017年05期

【摘要】：目的探讨短潜伏期体感诱发电位(SSEP)对慢性炎性脱髓鞘性多发性神经根神经病(CIDP)的诊断作用。方法 48例确诊或可能CIDP患儿及40例健康对照儿童进行肌电图神经传导和/或SSEP检查(健康对照仅行SSEP检查)。肌电图神经传导检查采用4道肌电图仪进行,包括至少4条运动神经和2条感觉神经;SSEP主要观察正中神经的N6(肘部电位),N13(颈髓电位),N20(皮质电位);胫神经的N8(乆窝电位),N22(腰髓电位),P39(皮质电位)。结果肌电图神经传导检测提示,48例患儿中35例运动、感觉神经均脱髓鞘,符合CIDP确诊标准;8例为感觉神经脱髓鞘,5例为轴突变性为主。40例患儿SSEP异常(未符合CIDP确诊标准的8例感觉受累患儿和5例继发轴突变性患儿的SSEP均异常),其中7例可见臂丛神经干和/或后根水平传导异常,33例同时有腰骶丛和/或后根损害。与健康对照相比,CIDP患儿N13、N22波幅潜伏期明显延长(P0.05)。结论 SSEP可用于CIDP辅助诊断,特别是对于感觉神经受累为主或继发轴突变性的CIDP患儿。
[Abstract]:Objective to investigate the role of short latency somatosensory evoked potential (SSEP) in the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). Methods EMG nerve conduction and / or SSEP examination were performed in 48 children with CIDP and 40 healthy controls. The nerve conduction of electromyogram (EMG) was examined by 4 channel electromyogram instrument (EMG). Including at least 4 motor nerves and 2 sensory nerves, N6 (elbow potential / N13) (cervical spinal cord potential / N20) and tibial nerve (N8) were observed mainly in median nerve (P _ (39) (P _ (39). Results the electromyographic nerve conduction test showed that 35 of 48 children with motor and sensory nerves were demyelinated. SSEP abnormality was found in 8 cases of sensory demyelination and 5 cases of axonal degeneration. SSEP abnormality was found in 8 cases of sensory nerve demyelination and 5 cases of secondary axonal degeneration in 8 cases of sensory involvement and 5 cases of secondary axonal degeneration which did not meet the criteria of CIDP diagnosis. Abnormal horizontal conduction of the trunk and / or posterior root of brachial plexus was found in 7 cases, and the lesion of lumbosacral plexus and / or posterior root was found in 33 cases. Compared with the healthy controls, the incubation period of N13 and N22 amplitudes in CIDP children was significantly prolonged (P 0.05). Conclusion SSEP can be used in the auxiliary diagnosis of CIDP, especially in children with sensory nerve involvement or secondary axonal degeneration.
【作者单位】：武汉市妇女儿童医疗保健中心神经电生理室;湖北省新华医院神经内科;
【基金】：武汉市科技创新平台-儿童神经疾病临床医学研究中心资助项目(武科计2014-160号)
【分类号】：R744.5

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