Fine E J, Soria E, Paroski M W, Petryk D, Thomasula L
Department of Neurology State University of New York.
Muscle Nerve. 1990 Feb;13(2):158-64. doi: 10.1002/mus.880130213.
Reports of the incidence and severity of physiological abnormalities of vitamin B12 deficiency sharply differ. To resolve these controversies we performed evoked response and nerve conduction studies in 10 males with vitamin B12 deficiency. The minimum criteria for this diagnosis were diminished position and vibration sensation and vitamin B12 levels less than 220 pg/ml. We found normal BAERs in 9/10 patients. The central interpeak latencies of the median and peroneal SERs were abnormal in 4/10 and 8/8 patients, respectively. The VERs were abnormal in 7/10 patients. We found absent or diminished amplitudes of sural sensory and peroneal motor action potentials in 8/10 patients. Abnormal peroneal F response chronodispersion was present in 7/10 patients. Nerve conduction velocities (NCV) were normal in 9/10 patients. EMG demonstrated abnormalities consistent with denervation in lower extremity muscles in 8/10 patients. These studies present a profile of vitamin B12 deficiency: essentially normal BAERs, mildly abnormal VERs and median SERs, and markedly abnormal peroneal SERs. NCV studies are consistent with sensory-motor axonopathy.
关于维生素B12缺乏所致生理异常的发生率及严重程度的报告差异很大。为解决这些争议，我们对10名维生素B12缺乏的男性进行了诱发电位和神经传导研究。该诊断的最低标准为位置觉和振动觉减退以及维生素B12水平低于220 pg/ml。我们发现10名患者中有9名的脑干听觉诱发电位（BAERs）正常。正中神经和腓总神经体感诱发电位（SERs）的中枢峰间潜伏期分别在4/10和8/8的患者中异常。视觉诱发电位（VERs）在7/10的患者中异常。我们发现10名患者中有8名的腓肠感觉神经动作电位和腓总运动神经动作电位的波幅缺失或降低。10名患者中有7名存在异常的腓总神经F反应时限离散。10名患者中有9名的神经传导速度（NCV）正常。肌电图显示10名患者中有8名存在与下肢肌肉失神经一致的异常。这些研究展示了维生素B12缺乏的特征：基本正常的BAERs、轻度异常的VERs和正中神经SERs，以及明显异常的腓总神经SERs。NCV研究结果与感觉运动轴索性神经病相符。
