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[I型Chiari畸形合并脊髓空洞症的诱发电位——病例报告]

[Evoked potentials in Chiari-malformation type I with syringomyelia--a case history].

作者信息

Utzig N, Burtzlaff C, Wiersbitzky H, Lauffer H

机构信息

Klinik für Kinder- und Jugendmedizin; Abt. für Neuropädiatrie und Stoffwechselkrankheiten, Ernst-Moritz-Arndt Universität Greifswald.

出版信息

Klin Padiatr. 2003 Jul-Aug;215(4):241-3. doi: 10.1055/s-2003-41402.

Abstract

The Chiari-syndrome Type I being a malformation of the posterior cranial fossa often leads to syringomyelia. The disease becomes apparent in adolescence with kyphoscoliosis, headache, vertigo, ataxy, hearing loss, partial paralysis and other neurological disorders. The onset is typically characterized by dissociated anesthesia, due to the frequent localization of the syrinx in the neighborhood of the posterior column of the spinal cord. It is reported a case of an 15-years-old-girl suffering from intensive headache, recurrent left-sided paresthesias and progredient scoliosis. Somatosensory evoked potentials of left ulnar and tibial nerves revealed a complete loss of cortical response. Diagnostic imaging showed an Chiari-malformation I with herniation of cerebellar tonsils and secondary syringomyelia of the cervical spinal cord. After surgical treatment with posterior fossa decompression, C1 laminectomy and partial excision of cerebellar tonsils the patient had a clear improvement in symptoms. Postsurgical the width of cervical syrinx decreases. Now somatosensory evoked potentials of the left ulnar and tibial nerves show amplitude-reduced cortical responses with a normal latency.

摘要

I型Chiari综合征是一种后颅窝畸形,常导致脊髓空洞症。该病在青少年期表现为脊柱后凸侧弯、头痛、眩晕、共济失调、听力丧失、部分瘫痪及其他神经系统疾病。由于脊髓空洞症常位于脊髓后柱附近,其发病通常以分离性感觉障碍为特征。报道了一例15岁女孩,患有剧烈头痛、反复发作的左侧感觉异常和进行性脊柱侧弯。左侧尺神经和胫神经的体感诱发电位显示皮层反应完全丧失。诊断性影像学检查显示I型Chiari畸形,小脑扁桃体疝和颈髓继发性脊髓空洞症。经后颅窝减压、C1椎板切除术和部分小脑扁桃体切除术治疗后,患者症状明显改善。术后颈髓空洞宽度减小。现在左侧尺神经和胫神经的体感诱发电位显示皮层反应波幅降低,但潜伏期正常。

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