Todnem K, Nyland H, Riise T, Kambestad B K, Vaernes R, Hjelle J O, Svihus R, Aarli J A
Department of Neurology, Haukeland Hospital, University of Bergen, Norway.
Undersea Biomed Res. 1990 Mar;17(2):95-107.
Eighteen professional divers (age range 24-33 yr, mean 28.3) participated in one simulated dive to 360 meters of seawater (msw) in a helium-oxygen (heliox) atmosphere with equal compression and decompression profiles. All divers were given an extensive neurologic examination before diving. Clinical neurologic symptoms observed during the dives were equilibrium disorder, sleep disturbances, fatigue, nausea, loose stools, stomach pain, tremor, mental disturbances, reduced appetite, and headache. Symptoms were scored individually by each diver. The symptoms were analyzed statistically by factor analysis, which grouped them into four factors. These symptoms are presumably related to functional disturbances in the brain stem and the cerebellum. Factor 3 symptoms (tremor, mental disturbances, reduced appetite) correlated significantly to a history of predive decompression sickness (P = 0.006) and to cerebral concussion (P = 0.023). Three divers were periodically unable to work at bottom due to equilibrium disorder, diarrhea, or nausea. One diver with mild polyneuropathy and slight cerebral atrophy as seen by computerized tomography and another diver with abnormal electroencephalography were periodically unable to work due to equilibrium disorder and nausea, respectively. We advocate that divers with signs of central or peripheral nervous system dysfunction should not be selected for deep diving.
18名职业潜水员（年龄范围24 - 33岁，平均28.3岁）参与了一次在氦氧（heliox）环境下模拟至360米海水深度（msw）的潜水，压缩和减压过程相同。所有潜水员在潜水前都接受了全面的神经学检查。潜水过程中观察到的临床神经症状包括平衡障碍、睡眠障碍、疲劳、恶心、腹泻、胃痛、震颤、精神障碍、食欲减退和头痛。每位潜水员对症状进行单独评分。通过因子分析对症状进行统计学分析，将其分为四个因子。这些症状可能与脑干和小脑的功能障碍有关。因子3症状（震颤、精神障碍、食欲减退）与潜水前减压病病史（P = 0.006）和脑震荡（P = 0.023）显著相关。三名潜水员由于平衡障碍、腹泻或恶心，在水底时定期无法工作。一名经计算机断层扫描显示有轻度多发性神经病和轻度脑萎缩的潜水员，以及另一名脑电图异常的潜水员，分别因平衡障碍和恶心定期无法工作。我们主张，有中枢或周围神经系统功能障碍迹象的潜水员不应被选入深潜项目。
