Kadanka Z, Pukl Z, Bednarík J
Neurologická klinika FNsP Brno.
Cesk Neurol Neurochir. 1990 Nov;53(6):369-75.
The authors examined evoked motor potentials (MEP) of the upper extremities in a group of 43 patients with multiple sclerosis using transcranial cortical and spinal stimulation. As abnormal they rated a prolongation of the motor conduction time by more than 3 sigma above the mean value recorded in the control group or when the response could not be evoked. The central motor conduction time between the cortex and cervical spine was abnormal in 76.7% of patients. The authors did not find a correlation between the severity of the paresis and the degree of electrophysiological abnormality. In frust and mild pareses the sensitivity was 80%. The frequency of abnormalities correlated with the degree of the diagnostic certainty. In patients with a probable diagnosis (according to Poser) abnormalities were present in 41.6%, when the diagnosis was certain, in 90.3%. In prolongation of the time of central motor conduction among all abnormalities 65.1% were due to prolonged motor conduction and in 27.9% the response could not be evoked. MEP examination is a sensitive technique for the detection of clinical and subclinical lesions and as to its sensitivity it is better than visual EP.
作者使用经颅皮质和脊髓刺激,对43例多发性硬化症患者的上肢诱发运动电位(MEP)进行了检测。他们将运动传导时间延长超过对照组记录平均值3个标准差以上或无法诱发出反应的情况评定为异常。76.7%的患者皮质与颈椎之间的中枢运动传导时间异常。作者未发现轻瘫严重程度与电生理异常程度之间存在相关性。在顿挫型和轻度轻瘫中,敏感性为80%。异常频率与诊断确定性程度相关。在可能诊断为(根据波塞尔标准)多发性硬化症的患者中,41.6%存在异常;当诊断确定时,异常率为90.3%。在所有异常情况中,中枢运动传导时间延长的情况里,65.1%是由于运动传导延长,27.9%是无法诱发出反应。MEP检测是一种检测临床和亚临床病变的敏感技术,就其敏感性而言,它优于视觉诱发电位。