Uğurlu Fatma Gülçin, Tiftik Tülay, Kara Murat, Türkkan Canan, Ersöz Murat, Akkuş Selami, Özçakar Levent
From the Ankara Physical and Rehabilitation Medicine Training and Research Hospital (FGU, TT, MK, CT, ME); Department of Physical and Rehabilitation Medicine, Yıldırım Beyazıt University Medical School (SA); and Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (LÖ).
Am J Phys Med Rehabil. 2015 Jun;94(6):429-35. doi: 10.1097/PHM.0000000000000207.
The aim of this study was to evaluate morphologically and electrophysiologically the peripheral nerves of hemiplegic patients.
Thirty-three (18 women and 15 men) stroke patients were recruited. The mean (SD) age was 55.6 (11.3) yrs, and the mean (SD) disease duration was 14.2 (16.0) mos. Motor nerve conduction study of the median, ulnar, fibular, and tibial nerves as well as sensory nerve conduction study of the median, ulnar, and sural nerves were performed. Diameters and cross-sectional area (CSA) measurements of the median (wrist/midarm levels) and sciatic nerves (midthigh level) were acquired using a 7- to 12-MHz linear probe. The values of the nonparetic limbs were taken as controls.
Prolonged distal latency and slowed motor conduction velocity of the tibial nerve as well as reduced amplitudes of the median and ulnar nerves were observed on the paretic sides when compared with those of the nonparetic sides (all P < 0.05). The median and sciatic nerve cross-sectional area values were found to be smaller on the paretic sides when compared with the nonparetic sides (all P < 0.05). The median and ulnar nerve compound muscle action potential amplitudes (paretic side) were positively correlated with arm/hand Brunnstrom Motor Recovery Stage, disease duration, motor Functional Independence Measure score, and Functional Ambulation Category.
The peripheral nerves of stroke patients seem to be affected--morphologically and electrophysiologically--on the paretic side.
本研究旨在从形态学和电生理学方面评估偏瘫患者的周围神经。
招募了33名（18名女性和15名男性）中风患者。平均（标准差）年龄为55.6（11.3）岁，平均（标准差）病程为14.2（16.0）个月。对正中神经、尺神经、腓总神经和胫神经进行运动神经传导研究，同时对正中神经、尺神经和腓肠神经进行感觉神经传导研究。使用7至12MHz线性探头测量正中神经（腕部/上臂中部水平）和坐骨神经（大腿中部水平）的直径和横截面积（CSA）。将非瘫痪侧肢体的值作为对照。
与非瘫痪侧相比，瘫痪侧胫神经的远端潜伏期延长、运动传导速度减慢，正中神经和尺神经的波幅降低（均P<0.05）。与非瘫痪侧相比，发现瘫痪侧正中神经和坐骨神经的横截面积值较小（均P<0.05）。正中神经和尺神经复合肌肉动作电位波幅（瘫痪侧）与手臂/手部Brunnstrom运动恢复阶段、病程、运动功能独立性测量评分和功能性步行分类呈正相关。
中风患者的周围神经在瘫痪侧似乎在形态学和电生理学方面受到影响。
