Rutkove S B
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, TCC-810, Boston, Massachusetts 02215, USA.
Muscle Nerve. 2001 Dec;24(12):1622-6. doi: 10.1002/mus.1197.
Heat can induce conduction block (CB) in demyelinated neurons; whether cooling can reverse CB and increase strength is uncertain. In six patients with electrophysiologic evidence of peroneal neuropathy at the fibular neck with definite motor CB, standard motor nerve conduction studies were performed at 32 degrees C and then after the fibular neck region was cooled with an ice pack to 8 degrees -12 degrees C. In all patients, cooling increased the amplitude and area of the compound motor action potential obtained with popliteal fossa stimulation, decreasing the relative amplitude drop across the fibular neck from a mean of 78% to 55%. A concomitant increase in foot dorsiflexor strength was clearly observed in three of the six patients. Both the electrophysiologic and clinical changes readily reversed upon rewarming. These data support the belief that, in compressive neuropathies, cooling relieves conduction block in selected motor neurons, improving strength.
热可在脱髓鞘神经元中诱发传导阻滞（CB）；冷却是否能逆转CB并增强肌力尚不确定。对6例有明确运动CB的腓骨小头处腓总神经病变电生理证据的患者，先在32℃进行标准运动神经传导研究，然后用冰袋将腓骨小头区域冷却至8℃-12℃后再次进行研究。在所有患者中，冷却增加了腘窝刺激时复合运动动作电位的波幅和面积，使腓骨小头处相对波幅下降从平均78%降至55%。6例患者中有3例明显观察到足背屈肌力随之增强。复温后电生理和临床变化均迅速逆转。这些数据支持了以下观点，即在压迫性神经病变中，冷却可缓解部分运动神经元的传导阻滞，增强肌力。
