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关键词：脊髓型颈椎病；诱发电位；运动；F-波
【摘要】 目的 探讨磁电刺激运动诱发电位( MEP) 在脊髓型颈椎病 (CSM) 的应用价值，并对其临床相关性进行分析。方法 采用经颅磁、电刺激对30例脊髓型颈椎病病人以及年龄性别等相配匹的30名健康成人分别于外展小指肌、肱二头肌及下肢展短肌表面进行 MEP 的检测。结果 全部病人的 MEP 都出现异常,表现为潜伏期、中枢传导时间 (CMCT) 延长，时限增宽，波辐降低或不能引出。磁刺激 MEP 的 CMCT 和皮层刺激潜伏期与脊髓型颈椎病临床日本整形外科协会 (JOA) 评分间有密切相关性,能较好地反映 CSM 病人的病情。结论 MEP 在检测 CSM 病人运动功能方面具有定量评价作用。与电刺激相比,磁刺激MEP能更好地反映 CSM 病人的病情。
Comparison between transcranial magnetic and electrical motorevoked potentials in cervical spondylotic myelopathy as well as their clinical correlationstudy Huang Funan* , Cao Qilong,Shen Dingguo, et al. * The General Hospital of Chinese PLA, Beijing 100853
【Abstract】 Objective Toinvestigate the values of motor evoked potentials(MEPs) in cervical spondylotic myelopathy(CSM) and to compare transcranial magnetic stimulation MEP with electricalstimulation MEP as well as some other problems in MEP clinical applications.Methods 30 cervical spondylotic myelopathypatients and 30 matched healthy volenteers were examined by transcranial MEPs. Compoundmuscle action potentials(CMAPs) after transcranial stimulation were recorded from abductordigiti minimi, biceps and abductor hallucis brevis. Results All 30 patients had abnormal MEPs and manifested by elongation ofcortical latency and central motor conduction time(CMCT), widened CMAPs duration as wellas decreased amplitude or disappeared MEP. Correlation between abnormal degree of magneticMEP and CSM patients' clinical JOA scores is statistically significant, and the usage ofF-wave to calculate CMCT could improve its preciseness. The cortical and peripherallatencies of MEPs in healthy volenteers were well correlated with body height, but CMCTwas not. Conclusions Transcranialmagnetic and electrical MEPs can quantitatively eveluate the motor dysfuction of CSMpatients. Magnetic MEP is better correlated with clinical manifestations than electricalMEP and the uasage of F-wave is more precise in calculating the central motor conductiontime.
【Key words】 Cervical spondylotic myelopathy Evoked potentials ......
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