Hashimoto T, Sato H, Shindo M, Hayashi R, Ikeda S
Third Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
J Neurol Neurosurg Psychiatry. 2002 Nov;73(5):585-7. doi: 10.1136/jnnp.73.5.585.
Tremor is a rare manifestation after neck injury, and its physiological mechanism has not been elucidated. We studied the effects of torque loading and ischaemic nerve block on coarse postural tremor in the right upper extremity, which had developed in association with a C7-C8 radiculopathy after traumatic neck injury in a 55 year old man. Loading reduced the tremor frequency from 6.1 Hz to 4.2 Hz with corresponding electromyography (EMG) bursts at the same frequencies as the tremor. Ischaemic nerve block also reduced the tremor frequency from 6.2 Hz to 2.8 Hz, and the time course of the frequency was not in parallel with that of the size of the maximal M wave. A significant reduction of the tremor frequency by loading and ischaemic nerve block indicates a mechanical reflex mechanism underlying the tremor, and association of synchronous EMG bursts suggests an increase in gain in the stretch reflex loop. The stretch reflex loop plays an important role in generation of oscillation in tremor after neck injury.
震颤是颈部损伤后一种罕见的表现，其生理机制尚未阐明。我们研究了扭矩加载和缺血性神经阻滞对一名55岁男性创伤性颈部损伤后伴发C7 - C8神经根病时右上肢粗大姿势性震颤的影响。加载使震颤频率从6.1赫兹降至4.2赫兹，同时肌电图（EMG）爆发频率与震颤频率相同。缺血性神经阻滞也使震颤频率从6.2赫兹降至2.8赫兹，且频率的时间进程与最大M波大小的时间进程不平行。加载和缺血性神经阻滞导致震颤频率显著降低，表明震颤存在机械反射机制，同步EMG爆发的关联提示牵张反射环增益增加。牵张反射环在颈部损伤后震颤的振荡产生中起重要作用。
