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[脊髓背侧损伤的电生理及临床检查进展]

[Progress in electrophysiologic and clinical examination for dorsal spinal cord injury].

作者信息

Xu Shao-ting

机构信息

Department of Orthopaedic, Beijing Army General Hospital, Beijing 100700, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Apr;27(2):254-7.

Abstract

Electrophysiologic examination of dorsal spinal cord injury (DSCI) is focused on transcranial magnetic stimulation induced motor evoked potentials. It were recorded at thenar muscles, exector spinae muscle, intercostals muscle, and internal oblique muscles. In complete spinal cord injury, the exector musle motor evoked potentials may occur although clinically that muscle shows no recovery. The ipsilateral exector and internal oblique muscles may be distributed by non-cross fibers in cerebrospinal tract. The progress in clinical sensory examination includes cutaneous electrical perceptional sensory threshold and quantitative sensory test. The former is more sensitive than two-points discrepentive test. Quantitative sensory test includes light touch threshold, vibration perceptual threshold, thermal threshold, pain, and cutaneous axon flare respone. It has been used in DSCI patients above and below the injury level. The thermal threshold elevates above the injury level in complete and incomplete DSCI patients.

摘要

脊髓背侧损伤(DSCI)的电生理检查主要集中于经颅磁刺激诱发的运动诱发电位。这些电位在大鱼际肌、竖脊肌、肋间肌和腹内斜肌处记录。在完全性脊髓损伤中,尽管临床上该肌肉未显示恢复,但竖脊肌运动诱发电位可能会出现。同侧的竖脊肌和腹内斜肌可能由脊髓丘脑束中的非交叉纤维支配。临床感觉检查的进展包括皮肤电感知感觉阈值和定量感觉测试。前者比两点辨别试验更敏感。定量感觉测试包括轻触觉阈值、振动感觉阈值、热阈值、疼痛和皮肤轴突 flare 反应。它已用于损伤水平以上和以下的 DSCI 患者。在完全性和不完全性 DSCI 患者中,损伤水平以上的热阈值升高。

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