Schulte-Mattler W J, Jakob M, Zierz S
Neurologische Klinik und Poliklinik, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany.
J Neurol Sci. 1999 Jan 15;162(2):189-93. doi: 10.1016/s0022-510x(98)00321-9.
Slowing of sensory nerve conduction is an unexplained finding in patients with sporadic amyotrophic lateral sclerosis (ALS). To study the frequency of these abnormalities and to study if a predisposition to the development of entrapment neuropathies is causal, 23 patients with definite ALS and 23 age-matched healthy volunteers were investigated prospectively. Antidromic sensory and motor nerve conduction velocities (NCVs) were measured in ulnar and median nerves. Median sensory NCV was abnormally low in three patients if compared with the lower limit of the control group; and median sensory NCV was abnormally low in nine patients (six right, eight left hands) if compared with ipsilateral ulnar sensory NCV. Sensory nerve conduction data did not correlate with clinical findings, such as forearm weakness or usage of canes. Motor nerve conduction data did not correlate with sensory nerve conduction data, with the exception of distal motor latency of right median nerves, which correlated with right median sensory NCV. Our findings show how affection of sensory fibers of distal segments of median nerves can be detected in individual patients with ALS. Nerve entrapment may contribute to this affection, but it is not the only cause. This should be considered in discussions about diagnostic criteria for ALS.
感觉神经传导减慢是散发性肌萎缩侧索硬化症（ALS）患者中一个无法解释的发现。为了研究这些异常的发生率，并研究是否易患卡压性神经病是其病因，我们对23例确诊的ALS患者和23名年龄匹配的健康志愿者进行了前瞻性研究。测量了尺神经和正中神经的逆向感觉和运动神经传导速度（NCV）。与对照组下限相比，3例患者的正中感觉NCV异常低；与同侧尺神经感觉NCV相比，9例患者（6例右手，8例左手）的正中感觉NCV异常低。感觉神经传导数据与临床发现，如前臂无力或使用拐杖情况无关。运动神经传导数据与感觉神经传导数据无关，但右侧正中神经的远端运动潜伏期与右侧正中感觉NCV相关。我们的研究结果表明，在个别ALS患者中可以检测到正中神经远端节段感觉纤维的受累情况。神经卡压可能导致这种受累，但不是唯一原因。在关于ALS诊断标准的讨论中应考虑到这一点。
