Kovala T, Tolonen U, Pyhtinen J
Department of Clinical Neurophysiology, Oulu University Central Hospital, Finland.
Electroencephalogr Clin Neurophysiol. 1991 Jul-Aug;80(4):262-75. doi: 10.1016/0168-5597(91)90109-b.
Somatosensory potentials evoked by stimulation of the posterior tibial nerve (tibial nerve SEPs) were studied in 40 patients with supratentorial non-haemorrhagic cerebral infarction and in 25 control subjects, SEPs were recorded twice in 39 patients and thrice in 35 patients. The first examination was carried out 4-19 days after the onset of the symptoms, the second examination 56-100 days after the stroke, and the third examination 348-393 days after the stroke. Increased side-to-side differences in the P57 and N75 peak latencies and absence of the P40 peak were the most frequent abnormal findings. The latency abnormalities were associated with involvement of the subcortical white matter of the rolandic region. The absence of the P40 peak was, in contrast, closely related to the extension of the infarcted area into the cortical gray matter of the rolandic region. When all SEP abnormalities were taken into account 55% of patients showed at least one abnormality in the tibial nerve SEP during the acute stage, 51% of patients had abnormal SEPs in the second examination and 43% of patients in the third examination. A nearly significant decrease was observed in the number of latency abnormalities, but the number of amplitude abnormalities, including absent responses, did not change during the 1 year follow-up period.
对40例幕上非出血性脑梗死患者及25例对照者进行了胫后神经刺激诱发的体感诱发电位(胫神经SEP)研究。39例患者记录了2次SEP,35例患者记录了3次SEP。首次检查在症状出现后4 - 19天进行,第二次检查在卒中后56 - 100天进行,第三次检查在卒中后348 - 393天进行。P57和N75峰潜伏期双侧差异增大以及P40峰缺失是最常见的异常表现。潜伏期异常与中央前回区域皮质下白质受累有关。相比之下,P40峰缺失与梗死区域扩展至中央前回区域皮质灰质密切相关。若考虑所有SEP异常情况,55%的患者在急性期胫神经SEP至少有一项异常,51%的患者在第二次检查时SEP异常,43%的患者在第三次检查时SEP异常。在1年的随访期内,潜伏期异常的数量有近乎显著的减少,但包括反应缺失在内的波幅异常数量没有变化。