Friedli W G, Fuhr P
Department of Neurology, University Hospital, Basel, Switzerland.
J Neurol Neurosurg Psychiatry. 1990 May;53(5):391-7. doi: 10.1136/jnnp.53.5.391.
Electrical stimulation of the digital nerves of the index finger produces changes in the EMG signal during steady voluntary contraction of the first dorsal interosseous muscle. This electrocutaneous reflex (ECR) was studied in 90 patients classified into different categories according to diagnostic criteria for multiple sclerosis. In addition, pattern reversal visual evoked responses (VER), brainstem auditory evoked responses (BAER) as well as spinal and scalp recorded somatosensory evoked potentials (SSEP) were investigated by stimulating both the index finger and the posterior tibial nerve. The reflex response was altered uni- or bilaterally in 56 per cent of the patients and the abnormalities of the ECR were related to the categories of diagnostic probability. Pathological results were found in 28 per cent of the hands without clinical evidence of sensorimotor deficit. Although ECR abnormalities were often associated with clinical signs, significant correlation was found only with hyperreflexia and/or increased muscle tone in the corresponding upper limb. Pathological ECR were more common than pathological SSEPs with finger stimulation recorded under identical stimulus conditions. Fewer abnormalities were found by ECR testing than with VER, but the proportion of abnormal ECR was higher than that of BAER. ECR provides a valuable supplement to existing electrophysiological procedures for detecting lesions in the central nervous system.
在第一背侧骨间肌持续进行自主收缩期间，电刺激食指的指神经会使肌电图（EMG）信号发生变化。对90例根据多发性硬化症诊断标准分类的患者进行了这种皮肤电反射（ECR）研究。此外，通过刺激食指和胫后神经，研究了图形翻转视觉诱发电位（VER）、脑干听觉诱发电位（BAER）以及脊髓和头皮记录的体感诱发电位（SSEP）。56%的患者反射反应出现单侧或双侧改变，且ECR异常与诊断可能性类别相关。在28%的手部未发现有感觉运动功能障碍临床证据的情况下却出现了病理结果。虽然ECR异常常与临床体征相关，但仅在相应上肢的反射亢进和/或肌张力增加方面发现了显著相关性。在相同刺激条件下记录的手指刺激中，病理性ECR比病理性SSEP更常见。通过ECR测试发现的异常情况比VER少，但异常ECR的比例高于BAER。ECR为检测中枢神经系统病变的现有电生理程序提供了有价值的补充。
