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腓肠肌刺激引出的巴宾斯基反射与下行运动通路功能障碍

Babinski reflex by sural stimulation and dysfunction of descending motor pathway.

作者信息

Uysal H, Bahşi Y Z, Yurdakul M

机构信息

Department of Neurology, Sevgi Hospital, Ankara, Turkey.

出版信息

Electromyogr Clin Neurophysiol. 1999 Sep;39(6):361-6.

Abstract

The aim of the study was to find out the relationship between the Babinski reflex and flexor polysynaptic reflexes which was evaluated by sural nerve stimulation, and to evaluate the descending motor pathway in involvement by cervical and transcortical cranial stimulation (TCCS) in a group of patients that were diagnosed as having the Babinski sign with either hemiparetic of hemiplegic, due to a cerebrovascular accident. In the normal population no significant responses were seen from the EHL by sural stimulation and these responses were recorded from the BF with a latency of 88 msec. In the patients who had Babinski reflex responses, signs could be easily recorded from EHL by sural stimulation with a latency of 166 msec. In this group, reflex responses from the BF were recorded with a latency of approximately 100 msec. Responses from the EHL were evaluated in 100% ratio by TCCS with a latency of 33.4 msec. in the normal group. The responses recorded from EHL by TCCS and latency was 47.5 msec. in 35.7% of the patients, who having Babinski sign. In 100% of the normal population, responses were evaluated with a latency of 28.8 msec. from EHL by cervical stimulation. In only 55% of the patients having the Babinski sign, responses were recorded in the same limb with a latency was 32.3 msec. These results support a different mechanism that control the EHL muscle in comparison to the BF muscle having dysfunction of descending motor tracts due to a pyramidal lesion.

摘要

本研究的目的是通过腓肠神经刺激来找出巴宾斯基反射与屈肌多突触反射之间的关系,并通过颈髓和经皮质颅刺激(TCCS)来评估一组因脑血管意外导致偏瘫或半身不遂且诊断为有巴宾斯基征的患者的下行运动通路。在正常人群中,腓肠神经刺激未在拇长伸肌(EHL)观察到明显反应,而在比目鱼肌(BF)记录到反应,潜伏期为88毫秒。在有巴宾斯基反射反应的患者中,通过腓肠神经刺激可轻松在拇长伸肌记录到反应,潜伏期为166毫秒。在该组中,比目鱼肌的反射反应潜伏期约为100毫秒。在正常组中,经皮质颅刺激在拇长伸肌记录到反应的比例为100%,潜伏期为33.4毫秒。在有巴宾斯基征的患者中,经皮质颅刺激在拇长伸肌记录到反应的比例为35.7%,潜伏期为47.5毫秒。在100%的正常人群中,颈髓刺激在拇长伸肌记录到反应的潜伏期为28.8毫秒。在仅有55%有巴宾斯基征的患者中,在同一肢体记录到反应,潜伏期为32.3毫秒。这些结果支持一种不同的机制,该机制控制拇长伸肌,与因锥体束病变导致下行运动束功能障碍的比目鱼肌相比有所不同。

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