Kalita J, Guptar P M, Misra U K
Department of Neurology, Sanjay Gandhi PGI of Medical Sciences, India.
Spinal Cord. 1999 Sep;37(9):658-62. doi: 10.1038/sj.sc.3100894.
Observational study with sequential follow-up.
To study the role of somatosensory evoked potential (SEP) and motor evoked potential (MEP) in monitoring the effect of methyl prednisolone (MPS) therapy in acute transverse myelitis (ATM).
Tertiary care referral teaching hospital at Lucknow, India.
In the present study, nine patients with ATM whose age ranged between 12 and 42 years and three of whom were females have been included. They were subjected to clinical examination, median and tibial SEP and Central motor conduction time (CMCT) to upper and lower limbs. The clinical and evoked potential studies were repeated after 7 and 90 days of intravenous methyl prednisolone treatment for 5 days. The outcome was defined on the basis of a 3 month Barthel Index (BI) score into poor (BI<12) and good (BI>/=12).
All the patients had varying degrees of leg weakness ranging between grade 0 and 4 on the Medical Research Council scale. Upper limbs were weak in four patients. Pinprick and joint position sensations in the lower limb were impaired in all patients. Central motor conduction time to upper limb was abnormal in two patients and to lower limbs in eight patients. Median SEPs were normal in all and tibial in two patients. On the seventh day follow-up, muscle power improved in six which correlated with CMCT-to tibialis anterior in five patients. Joint position sense improved in two patients on the seventh day but there was no further improvement at 3 months. Tibial SEP, however, improved in four patients on the seventh day and six patients at 3 months. Following methyl prednisolone therapy, both sensory and motor functions improved, but the improvement was more pronounced and more frequent at 3 months compared to that on seventh day. At a 3 month follow-up, six patients had good and three poor recovery.
Evoked potential studies provide additional objective means for monitoring the effect of therapy in ATM.
序贯随访观察性研究。
探讨体感诱发电位（SEP）和运动诱发电位（MEP）在监测甲基强的松龙（MPS）治疗急性横贯性脊髓炎（ATM）疗效中的作用。
印度勒克瑙的三级医疗转诊教学医院。
本研究纳入9例年龄在12至42岁之间的ATM患者，其中3例为女性。对他们进行临床检查、正中神经和胫神经SEP以及上下肢的中枢运动传导时间（CMCT）检测。在静脉注射甲基强的松龙治疗5天后的第7天和第90天重复进行临床和诱发电位研究。根据3个月的巴氏指数（BI）评分将结果分为差（BI<12）和好（BI≥12）。
所有患者均有不同程度的腿部无力，医学研究委员会量表评分在0至4级之间。4例患者上肢无力。所有患者下肢的针刺觉和关节位置觉均受损。2例患者上肢的中枢运动传导时间异常，8例患者下肢的中枢运动传导时间异常。所有患者的正中神经SEP均正常，2例患者的胫神经SEP正常。在第7天随访时，6例患者的肌力有所改善，其中5例与胫前肌的CMCT相关。2例患者在第7天关节位置觉有所改善，但在3个月时没有进一步改善。然而，4例患者在第7天胫神经SEP有所改善，6例患者在3个月时有所改善。甲基强的松龙治疗后，感觉和运动功能均有改善，但与第7天相比，3个月时的改善更为明显和频繁。在3个月的随访中，6例患者恢复良好，3例患者恢复较差。
诱发电位研究为监测ATM的治疗效果提供了额外的客观手段。
Zotero 插件