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缝合后再生神经中的体感诱发电位皮层电位(作者译)

[Somatosensory evoked cortical potentials (SSEP) in regenerating nerves following suture (author's transl)].

作者信息

Assmus H

出版信息

EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1978 Sep;9(3):167-71.

PMID:100312
Abstract

In 37 patients with sutured median and ulnar nerves 106 SSEP were evaluated. Stimulation of the finger nerves was performed at a rate of 4-6/sec. In the early stage of reinnervation, just when the electrical stimulus was perceived, the second positive component (P2) of the SSEP could be recorded, but the primary part of the SEP (N1/P1) was highly reduced or absent. At this time no peripheral nerve action potential or muscle action potential could be obtained. In a follow-up study the sensory regenerating process expressed in a clinical sensibility index (S1-S4+), corresponded well with latency and amplitude of the primary potential of the SSEP: N1-latency decrease and N1/P1 and especially P2/N3-amplitude increase corresponded with improving sensibility. The abnormally high P2-wave is assumed to be an expression of central adaptation and reintegration. The method seems to be of diagnostic value as a test of peripheral nerve function especially in early and late stages of reinnervation, in verification of collateral reinnervation and in objectifying sensory defects in forensic cases.

摘要

对37例正中神经和尺神经缝合患者的106次体感诱发电位(SSEP)进行了评估。以4 - 6次/秒的频率刺激指神经。在神经再支配的早期,当刚能感知到电刺激时,可记录到SSEP的第二个正向成分(P2),但体感诱发电位的主要部分(N1/P1)高度降低或缺失。此时无法获得外周神经动作电位或肌肉动作电位。在一项随访研究中,用临床感觉指数(S1 - S4 +)表示的感觉再生过程与SSEP主要电位的潜伏期和波幅密切相关:N1潜伏期缩短以及N1/P1尤其是P2/N3波幅增加与感觉改善相对应。异常高的P2波被认为是中枢适应和重新整合的表现。该方法作为一种外周神经功能测试似乎具有诊断价值,尤其在神经再支配的早期和晚期、确认侧支神经再支配以及在法医案件中客观评估感觉缺陷方面。

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