Zgorzalewicz Małgorzata, Kilarski Dariusz, Nowak Rafał
Katedra i Klinika Neurologii Wieku Rozwojowego Akademii Medycznej, 60-355 Poznań, ul. Przybyszewskiego 49.
Przegl Lek. 2003;60 Suppl 1:28-33.
Somatosensory evoked potentials (SEP) are responses which appear under the influence of sensory stimuli, producing a series of bioelectric changes in the peripheral and central nervous system. Particular components of SEP are recorded from the stimulation point-at the wrist--of the examined median nerve through the brachial plexus, spinal cord and subcortical structures to gyrus postcentralis in the brain. The source of N 20 wave is found in the primary sensory cortex, while P 25 is the response from the somatosensory region of the cerebral cortex in the parietal lobe, in the region responsible for the upper limb. N9 deflection is generated by the stimulation wave, going along the brachial plexus (Erb's point). 50 children and adolescents at the age of 8-16 were examined. In the analysis of the obtained results the influence of sex, age, height, the length of upper limbs, head circumference and temperature of the examined patients' skin was taken into consideration. SEP recording was performed with the use of Multiliner equipment, (Toennies, Germany) according to the recommendation of the International Federation of Clinical Neurophysiology. The responses obtained during the stimulation of median nerves were recorded with the use of surface electrodes located at the head according to 10-20 system in C'3 and C'4 points and from the active electrode EP situated at Erb's point above the brachial plexus. Latencies and amplitude, component of short latency (N20, P25, N9) time differences of their appearance and the speed of nerve impulse conduction along stimulated fibres were analysed. There were significant relations found between latency of N9 and N20 waves and age, height and the length of limbs in examined patients but there were no relations found between P 25 appearance and the elements mentioned above. It was stated that the head circumference did not influence time of cortical waves appearance. Moreover, it was not found that growth of skin temperature within the range of 30-36 degrees C significantly influenced the acceleration of nerve impulse conduction along stimulated fibres. It was proved that SEP is a precise and non-invasive method which may be applied in children and adolescents. Interpretation of the obtained results requires consideration of anthropological parameters that change during the developmental age.
体感诱发电位（SEP）是在感觉刺激影响下出现的反应，会在周围和中枢神经系统中产生一系列生物电变化。SEP的特定成分是通过臂丛神经、脊髓和皮质下结构，从受检正中神经位于手腕处的刺激点记录到大脑中央后回。N20波的来源位于初级感觉皮层，而P25是顶叶大脑皮层体感区域对应上肢区域的反应。N9偏转是由沿臂丛神经（Erb点）传播的刺激波产生的。对50名8至16岁的儿童和青少年进行了检查。在分析所得结果时，考虑了受检患者的性别、年龄、身高、上肢长度、头围和皮肤温度的影响。SEP记录是使用Multiliner设备（德国Toennies公司）按照国际临床神经生理学会的建议进行的。在刺激正中神经期间获得的反应，是使用位于头部根据10 - 20系统在C'3和C'4点的表面电极以及位于臂丛神经上方Erb点的有源电极EP进行记录的。分析了潜伏期、波幅、短潜伏期成分（N20、P25、N9）出现的时间差异以及神经冲动沿受刺激纤维的传导速度。在受检患者中发现N9和N20波的潜伏期与年龄、身高和肢体长度之间存在显著关系，但未发现P25的出现与上述因素之间存在关系。研究表明头围不影响皮层波出现的时间。此外，未发现皮肤温度在30至36摄氏度范围内的升高会显著影响神经冲动沿受刺激纤维的传导加速。事实证明，SEP是一种可应用于儿童和青少年的精确且非侵入性的方法。对所得结果的解释需要考虑发育年龄期间变化的人类学参数。
