Cruz Martínez A, Tejada J
Unidad de Electromiografía, Clínica La Luz, Madrid, Spain.
Electromyogr Clin Neurophysiol. 1999 Sep;39(6):331-5.
Conduction of the central motor pathways (CMCT) by magnetic stimulation of the motor cortex (TMS) was performed in 17 patients with hereditary motor sensory neuropathy (HMSN) and 2 siblings with hereditary spastic paraplegia (HSP). CMCT was prolonged in two patients with HMSN I with associated pyramidal features and in two subjects with HMSN II without clinical pyramidal signs. CMCT may be abnormal in HMSN due to central motor pathways involvement or altered spinal excitability with increased synaptic delay. CMCT was normal in the upper limbs in patients with HSP but increased in the legs. Diagnostic yield of TMS increased in less disabled cases with HSP when selective conduction at the spinal level (C7-S1) was calculated. Abnormal spinal conduction in HSP is consistent with degeneration of the crossed corticospinal tracts at the thoracic level found in neuropathologic observations.
对17例遗传性运动感觉神经病（HMSN）患者和2例遗传性痉挛性截瘫（HSP）患者的同胞进行了经磁刺激运动皮层（TMS）的中枢运动通路传导（CMCT）检测。在2例伴有锥体束征的HMSN I型患者和2例无临床锥体束征的HMSN II型患者中，CMCT延长。由于中枢运动通路受累或脊髓兴奋性改变及突触延迟增加，HMSN患者的CMCT可能异常。HSP患者上肢的CMCT正常，但下肢增加。当计算脊髓水平（C7 - S1）的选择性传导时，TMS在残疾程度较轻的HSP病例中的诊断率增加。HSP患者脊髓传导异常与神经病理学观察中发现的胸段交叉皮质脊髓束变性一致。
