Department of Neurology and Neurological Science, Tokyo Medical and Dental University Graduate School, Tokyo 113-8519, Japan.
Muscle Nerve. 2011 Feb;43(2):274-82. doi: 10.1002/mus.21855.
In this study we aim to establish a motor nerve conduction study (NCS) for the cauda equina and examine its usefulness in multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS). NCS of the tibial nerve proximal to the knee was performed with an optimized high-voltage electrical stimulation (HV-ES) method in 21 normal subjects, 5 with MMN, and 11 with ALS. HV-ES, but not magnetic stimulation, could supramaximally stimulate the cauda equina. Cauda equina motor conduction time determined by HV-ES, but not that with F-waves, correlated well with cauda equina length on magnetic resonance imaging. HV-ES revealed proximal lesions in 4 MMN patients but in none of the ALS patients. Importantly, 1 patient with "MMN without conduction block (CB)" had a CB in the cauda equina. Cauda equina motor conduction is better evaluated by HV-ES than with F-wave study or magnetic stimulation. HV-ES can help to distinguish MMN and "MMN without CB" from ALS.
在这项研究中，我们旨在建立马尾神经根的运动神经传导研究（NCS），并研究其在多发性运动神经病（MMN）和肌萎缩侧索硬化症（ALS）中的应用。我们对 21 名正常受试者、5 名 MMN 患者和 11 名 ALS 患者的膝关节近端胫神经进行了优化的高压电刺激（HV-ES）NCS。HV-ES 而不是磁刺激可以超刺激马尾神经根。HV-ES 确定的马尾神经根运动传导时间与磁共振成像上的马尾神经根长度相关性良好，但 F 波的相关性则不然。HV-ES 在 4 名 MMN 患者中发现了近端病变，但在 ALS 患者中则没有。重要的是，1 名“无传导阻滞的 MMN（MMN without CB）”患者在马尾神经根中存在 CB。与 F 波研究或磁刺激相比，HV-ES 更能评估马尾神经根的运动传导。HV-ES 有助于区分 MMN 和“无 CB 的 MMN”与 ALS。
