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先天性甲状腺功能减退症的体感诱发电位和听觉脑干反应。I. 对6例新生儿期确诊的婴儿治疗前后的纵向研究。

Somatosensory evoked potentials and auditory brain-stem responses in congenital hypothyroidism. I. A longitudinal study before and after treatment in six infants detected in the neonatal period.

作者信息

Laureau E, Vanasse M, Hebert R, Letarte J, Glorieux J, Desjardins M, Dussault J H

出版信息

Electroencephalogr Clin Neurophysiol. 1986 Dec;64(6):501-10. doi: 10.1016/0013-4694(86)90186-0.

Abstract

We report the results of a longitudinal study of auditory brain-stem responses (ABRs) and somatosensory evoked potentials (SEPs) performed in 6 children with congenital hypothyroidism. These infants were detected by the Quebec Network for Genetic Medicine and treated early. ABRs and SEPs were recorded both before and 2 weeks after the initiation of therapy and at 6 months of age. Before treatment, for SEP, we found increased wave N19, P22 latencies and N13-N19, N19-P22 interpeak latencies (IPLs) in congenital hypothyroid (CH) children. For ABR, there were increased wave I latencies with normal I-V IPLs. Substitutive therapy improved these abnormalities although this improvement was more evident after a shorter period of time for ABRs than for SEPs. Even at 6 months, 2 CH children still showed increased N13-N19 IPLs. Both had very low serum T4 levels at the time of diagnosis and one had also a very small knee surface area, both criteria indicating a severe hypothyroidism. It will be interesting to verify if initial and persisting increase of N13-N19 IPL is associated with later neuropsychological problems.

摘要

我们报告了一项针对6名先天性甲状腺功能减退症儿童进行的听觉脑干反应(ABR)和体感诱发电位(SEP)纵向研究的结果。这些婴儿由魁北克遗传医学网络检测出,并得到了早期治疗。在治疗开始前、治疗开始后2周以及6个月大时记录ABR和SEP。治疗前,对于SEP,我们发现先天性甲状腺功能减退(CH)儿童的N19波、P22波潜伏期以及N13 - N19、N19 - P22峰间潜伏期(IPL)增加。对于ABR,I波潜伏期增加,而I - V IPL正常。替代疗法改善了这些异常情况,不过ABR的改善在较短时间内比SEP更明显。即使在6个月时,仍有2名CH儿童的N13 - N19 IPL增加。这两名儿童在诊断时血清T4水平都非常低,其中一名儿童的膝表面积也非常小,这两个标准都表明是严重的甲状腺功能减退。验证N13 - N19 IPL的初始增加和持续增加是否与后期的神经心理问题相关将是很有趣的。

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