Brown W F, Snow R
Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada.
Stroke. 1990 Dec;21(12):1700-4. doi: 10.1161/01.str.21.12.1700.
This study examined the frequency of denervation activity in hemiplegic muscles in relation to the size and location of the central lesion. We studied 20 patients, 14 with major unilateral cerebral infarctions in the middle cerebral or internal carotid territories; four with a single lacune in the pons, internal capsule, or thalamus; and two with precentral infarcts. Using somatosensory evoked potentials, motor conduction studies, and assessments of conduction across the plexus and roots, we detected no conduction abnormalities on the affected side. Fibrillation was common in both groups, especially in distal and intermediate muscles. The distribution of the fibrillation and the normal conduction studies suggested that trauma of peripheral nerves was not a factor. Although the normal conduction studies and pattern of fibrillation activity do not exclude peripheral nerve trauma as the cause of the fibrillation, we suggest that transsynaptic degeneration is a reasonable alternative explanation.
本研究探讨了偏瘫肌肉中失神经活动的频率与中枢病变大小及位置的关系。我们研究了20例患者，其中14例在大脑中动脉或颈内动脉区域发生单侧大面积脑梗死；4例在脑桥、内囊或丘脑有单个腔隙性梗死；2例有中央前回梗死。通过体感诱发电位、运动传导研究以及对神经丛和神经根传导的评估，我们在患侧未检测到传导异常。两组中纤颤均很常见，尤其是在远端和中间肌肉。纤颤的分布以及正常的传导研究表明，周围神经损伤不是一个因素。虽然正常的传导研究和纤颤活动模式不能排除周围神经损伤是纤颤的原因，但我们认为跨突触变性是一个合理的替代解释。
