Tsai S Y, Tchen P H, Chen J D
Department of Neurology, Tao-Yuan General Hospital, Taiwan, Republic of China.
Electromyogr Clin Neurophysiol. 1992 Dec;32(12):615-20.
Forty-one stroke patients and 41 normal controls of matched age, sex and body height were studied by magnetic stimulation of the motor cortex and lower cervical area. The cortical and cervical motor evoked potentials (MEPs) were detected from the abductor pollicis brevis muscle. The amplitudes and latencies of cortical MEPs, central conduction time (CCT), and interside difference of bilateral CCT (DCCT) in stroke patients showed significant difference in comparison with normal controls. The degree of motor weakness was statistically correlated with the severity of cortical MEP findings, but not with the deep tendon reflex and Babinski sign. The abnormal rate of cortical MEP was higher in patients with hemorrhage than in those with infarction. Six out of 17 patients with hemorrhage had prolonged CCT or DCCT, but only 3 out of 24 patients with infarction had the same findings. The cortical MEP findings in putaminal hemorrhage were more severe than in thalamic hemorrhage. In instances of infarction involving total middle cerebral artery territory (cortical and subcortical areas), the cortical MEP was absent in all cases (4/4). It was concluded that cortical MEP findings in stroke patients examined by magnetic stimulation showed good correlation both with the lesion radiologically and the motor deficit clinically. This is an acceptable method for quantitative evaluation of motor system function in stroke.
通过对运动皮层和下颈段区域进行磁刺激，对41例中风患者以及41例年龄、性别和身高相匹配的正常对照者进行了研究。从拇短展肌检测皮层和颈段运动诱发电位（MEP）。与正常对照相比，中风患者的皮层MEP的波幅和潜伏期、中枢传导时间（CCT）以及双侧CCT的两侧差值（DCCT）均有显著差异。运动无力程度与皮层MEP表现的严重程度在统计学上相关，但与深腱反射和巴宾斯基征无关。出血性中风患者的皮层MEP异常率高于梗死性中风患者。17例出血性中风患者中有6例CCT或DCCT延长，但24例梗死性中风患者中只有3例有相同表现。壳核出血的皮层MEP表现比丘脑出血更严重。在累及大脑中动脉全部区域（皮层和皮层下区域）的梗死病例中，所有病例（4/4）的皮层MEP均消失。得出的结论是，通过磁刺激检查的中风患者的皮层MEP表现与影像学病变和临床运动功能障碍均具有良好的相关性。这是一种用于定量评估中风患者运动系统功能的可接受方法。
