Schimsheimer R J, Ongerboer de Visser B W, Bour L J, Kropveld D, Van Ammers V C
Department of Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands.
Electroencephalogr Clin Neurophysiol. 1988 Oct;70(4):313-24. doi: 10.1016/0013-4694(88)90050-8.
Peak latencies of somatosensory evoked potentials (SEPs) from nerves of the first digit (digit 1-SEP), 39 controls, and third digit (digit 3-SEP), 47 controls, and indicated for Erb's point, second cervical vertebra (Cv2) and contralateral cortical hand area correlated significantly with arm length. Single regression analysis for arm length for Erb's potentials and the Cv2 potential in digit 1-SEP, and multiple regression analysis for arm length and age for the Cv2 potential in digit 3-SEP, the cortical potentials and flexor carpi radialis H reflex were used for demonstration of root C6 or C7 pathology. Upper crossing of +3 S.D. was defined as abnormal. The combined examination yielded abnormalities in 81% of our 22 patients operated for compression of root C6 or C7 due to cervical disc protrusion. A minority of the patients showed multiple positive correlations between symptoms and electrophysiologic and myelographic findings. In others only one or the other investigative procedure provided confirmatory information, while, in a notable number (6 patients), these approaches revealed abnormalities when there were no or non-specific symptoms. The presented electrophysiological investigations are useful to determine the presence and severity of root C6 or C7 compression as well as the functional relevance of a myelographic abnormality.
来自食指神经(食指体感诱发电位,39名对照者)、中指神经(中指体感诱发电位,47名对照者)的体感诱发电位(SEP)的峰值潜伏期,以及在臂丛点、第二颈椎(Cv2)和对侧皮质手部区域所测结果与臂长显著相关。对食指SEP中臂丛电位和Cv2电位的臂长进行单因素回归分析,对中指SEP中Cv2电位的臂长和年龄进行多因素回归分析,利用皮质电位和桡侧腕屈肌H反射来证实C6或C7神经根病变。超过+3标准差被定义为异常。在我们22例因颈椎间盘突出导致C6或C7神经根受压而接受手术的患者中,联合检查发现81%存在异常。少数患者的症状与电生理和脊髓造影结果之间存在多重正相关。在其他患者中,只有一种或另一种检查方法提供了确诊信息,而在相当数量(6例)的患者中,这些检查方法在没有症状或症状不特异时发现了异常。所介绍的电生理检查对于确定C6或C7神经根受压的存在和严重程度以及脊髓造影异常的功能相关性很有用。