对中风患者患侧和未患侧肢体在急性和亚急性期发生的卡压性神经病变进行电生理分析。

Electrophysciological analysis of entrapment neuropathies developed in acute and subacute period in paretic and non-paretic extremities in patients with stroke.

作者信息

Odabas Faruk Omer, Sayin Refah, Milanlioglu Aysel, Tombul Temel, Cögen Etem Emre, Yildirim Gökhan

机构信息

Yuzuncu Yil University, Faculty of Medicine, Department of Neurology, Van, Turkey.

出版信息

J Pak Med Assoc. 2012 Jul;62(7):649-52.

PMID:23866507

Abstract

OBJECTIVE

To investigate entrapment neuropathies in stroke patients in a hospital in Turkey with Medical Research Council (MRC) score < or = 2/5 and in those with MRC score > or = 3/5.

METHODS

The study comprising 40 patients from January 2008 to June 2009 in the Stroke Unit of the Department of Neurology, Yuzuncu Yil University in Van, Turkey, entailed electrophysiological analysis of median, ulnar, radial nerves, peroneal, tibial and sural nerves in paretic and nonparetic upper and lower extremities. National Institute of Health Stroke scale was used for the evaluation of neurological deficient, while nerve conduction studies were performed for the diagnosis of entrapment neuropathies (EN). The patients were divided into two groups based on their initial Medical Research Council (MRC) score: < 2/5 and > 3/5. Both groups had 20 patients each. The readings were compared in the control phase 45 to 50 days after the stroke. Paired samples test and t-test using SPSS version 15 were used for statistical analysis.

RESULTS

Carpal tunnel syndrome (CTS) at wrist was found in 7 (35%) patients, cubital tunnel syndrome at elbow in 3 (15%) patients, and evident reduction in motor action potential values of peroneal, median and ulnar nerve in 10 (50%) patients in the control studies for conduction on our patients with Medical Research Council (MRC) score of < or = 2/5, unlike the initial findings, in the paretic side. Among the patients, in the other group, 2 (10%) developed bilateral Carpel tunnel syndrome, and it was also detected in the healthy upper extremities in 2 (10%) more patients. In the control studies for conduction in patients with Medical Research Council score of 3/5, Carpel tunnel syndrome was detected in the healthy side in 4 (20%) patients and in the affected side in 3 (15%) patients.

CONCLUSION

In patients with severe paresis, if the affected extremity is not functional, symptoms of entrapment neuropathy are easy to occur.

摘要

目的

调查土耳其一家医院中，医学研究委员会（MRC）评分≤2/5以及MRC评分≥3/5的中风患者的卡压性神经病。

方法

该研究纳入了2008年1月至2009年6月期间，土耳其凡城于祖尔恰伊大学神经病学系卒中单元的40例患者，对其瘫痪及未瘫痪的上下肢的正中神经、尺神经、桡神经、腓总神经、胫神经和腓肠神经进行电生理分析。采用美国国立卫生研究院卒中量表评估神经功能缺损情况，同时进行神经传导研究以诊断卡压性神经病（EN）。根据患者最初的医学研究委员会（MRC）评分将患者分为两组：<2/5和>3/5。两组各有20例患者。在卒中后45至50天的对照阶段比较读数。使用SPSS 15版进行配对样本检验和t检验进行统计分析。

结果

在MRC评分≤2/5的患者中，对照研究发现7例（35%）患者存在腕部腕管综合征（CTS），3例（15%）患者存在肘部肘管综合征，10例（50%）患者腓总神经、正中神经和尺神经的运动动作电位值明显降低，与初始结果不同，出现在瘫痪侧。在另一组患者中，2例（10%）出现双侧腕管综合征，另外2例（10%）患者的健康上肢也检测到该综合征。在MRC评分为3/5的患者的对照传导研究中，4例（20%）患者的健康侧检测到腕管综合征，3例（15%）患者的患侧检测到该综合征。