Department of Neurology, Japanese Red Cross Medical Center, Tokyo, Japan.
J Neurol Sci. 2013 Aug 15;331(1-2):174-6. doi: 10.1016/j.jns.2013.06.005. Epub 2013 Jun 25.
Useful diagnostic techniques for the acute phase of sciatic nerve palsy, an entrapment neuropathy, are not well established. The aim of this paper is to demonstrate the diagnostic utility of magnetic sacral motor root stimulation for sciatic nerve palsy. We analyzed the peripheral nerves innervating the abductor hallucis muscle using both electrical stimulations at the ankle and knee and magnetic stimulations at the neuro-foramina and conus medullaris levels in a patient with sciatic nerve palsy at the level of the piriformis muscle due to gluteal compression related to alcohol consumption. On the fourth day after onset, magnetic sacral motor root stimulation using a MATS coil (the MATS coil stimulation method) clearly revealed a conduction block between the knee and the sacral neuro-foramina. Two weeks after onset, needle electromyography supported the existence of the focal lesion. The MATS coil stimulation method clearly revealed a conduction block in the sciatic nerve and is therefore a useful diagnostic tool for the abnormal neurophysiological findings associated with sciatic nerve palsy even at the acute phase.
用于坐骨神经麻痹（嵌压性神经病）急性期的有用诊断技术尚未很好确立。本文旨在展示磁刺激骶神经根在坐骨神经麻痹诊断中的应用价值。我们分析了一位因酒精摄入导致臀肌受压而出现梨状肌水平坐骨神经麻痹患者的足部外展肌的周围神经，使用踝部和膝部的电刺激以及神经孔和脊髓圆锥水平的磁刺激。在发病后第 4 天，使用 MATS 线圈（MATS 线圈刺激法）进行的磁刺激骶神经根显示出膝关节与骶神经孔之间存在传导阻滞。发病后 2 周，针肌电图支持局灶性病变的存在。MATS 线圈刺激法可清晰显示坐骨神经中的传导阻滞，因此，即使在急性期，对于与坐骨神经麻痹相关的异常神经生理发现，该方法也是一种有用的诊断工具。
