Nové-Josserand A, André-Obadia N, Mauguière F
Service de Neurologie Fonctionnelle et d'Epileptologie, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, 59, boulevard Pinel, 69394 Lyon.
Rev Neurol (Paris). 2002 Dec;158(12 Pt 1):1191-7.
Somatosensory and motor evoked potentials (EPs) have been recorded in 38 patients with cervical spondylosis, documented by MRI. All were symptomatic, 23 presented with myelopathy. Somatosensory evoked potentials were abnormal in 66p.cent as well as motor evoked potentials. The N13 potential, generated by the posterior dorsal horn of the cervical spinal cord, was abnormal in 63p.cent of patients and was the only disorder detected in 12p.cent. Together, somatosensory and motor evoked potentials were abnormal in 82p.cent of patients. There was no correlation between EPs findings and radiological data. Similary, MRI and clinical data were agreeing in only 50p.cent of patients. When a spondylotic myelopathy is suspected, SEPs proved more sensitive to detect somatosensory dysfunctionning than clinical testing and radiological data were discordant with clinical status in 50p.cent of cases. In order to obtain a high sensitivity, both somatosensory and motor evoked potentials should be recorded on all limbs with a special attention to segmental cervical and cervico-medullary responses. EPs data help to identify patients with cervical cord dysfunction and thus contribute to the therapeutic decision for surgery.
对38例经磁共振成像（MRI）确诊的颈椎病患者记录了体感诱发电位（SEPs）和运动诱发电位（EPs）。所有患者均有症状，23例表现为脊髓病。66%的患者体感诱发电位异常，运动诱发电位也异常。由颈脊髓后角产生的N13电位在63%的患者中异常，且在12%的患者中是唯一检测到的异常。总体而言，82%的患者体感诱发电位和运动诱发电位均异常。诱发电位结果与放射学数据之间无相关性。同样，MRI与临床数据仅在50%的患者中相符。当怀疑存在脊髓型颈椎病时，体感诱发电位在检测体感功能障碍方面比临床检查更敏感，且在50%的病例中放射学数据与临床状况不一致。为了获得高敏感性，应在所有肢体上记录体感诱发电位和运动诱发电位，特别关注颈段和颈髓节段的反应。诱发电位数据有助于识别颈髓功能障碍患者，从而有助于手术治疗决策。
