Oh Mi-Kyoung, Kim Hye-Ri, Kim Won-Seok, Shin Hyung Ik
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Department of Rehabilitation Medicine, National Rehabilitation Hospital, Seoul, Korea.
Ann Rehabil Med. 2017 Apr;41(2):211-217. doi: 10.5535/arm.2017.41.2.211. Epub 2017 Apr 27.
To investigate the relationship between motor evoked potential (MEP) response and the severity of motor paralysis, evaluated according to the Korean disability evaluation system in patients with spinal cord injury (SCI).
We analyzed 192 lower limbs of 96 SCI patients. Lower limbs were classified according to their motor scores, as determined by the International Standards for Neurological Classification of Spinal Cord Injury: motor score <10 (group 1); ≥10 and <15 (group 2); ≥15 and <20 (group 3); and ≥20 (group 4). MEP responses were classified as 'normal', 'delayed' or 'absent', based on their onset latency, which was compared between the different motor score groups.
MEP responses and limb motor scores were highly correlated (p<0.001). There was a significant difference of MEP responses between the motor score groups (p<0.001). MEP response was markedly poorer in motor group 1 (limb motor score <10) than in the other three groups (p<0.0001). However, there were no differences between the three groups with motor scores of 10 or above.
Clinical utility of MEP as a complimentary tool to manual muscle tests could be limited to discriminating motor score groups with severe paralysis, i.e., single lower limb motor power grades of 0 or 1, and from grade 2, 3, and 4, or above, in the Korean disability evaluation system.
根据韩国残疾评估系统，探讨脊髓损伤（SCI）患者运动诱发电位（MEP）反应与运动麻痹严重程度之间的关系。
我们分析了96例SCI患者的192条下肢。根据国际脊髓损伤神经分类标准确定的运动评分对下肢进行分类：运动评分<10（第1组）；≥10且<15（第2组）；≥15且<20（第3组）；≥20（第4组）。根据MEP反应的起始潜伏期将其分类为“正常”、“延迟”或“缺失”，并在不同运动评分组之间进行比较。
MEP反应与肢体运动评分高度相关（p<0.001）。运动评分组之间的MEP反应存在显著差异（p<0.001）。第1运动组（肢体运动评分<10）的MEP反应明显比其他三组差（p<0.0001）。然而，运动评分在10分及以上的三组之间没有差异。
在韩国残疾评估系统中，MEP作为手动肌力测试的补充工具的临床效用可能仅限于区分严重麻痹的运动评分组，即单下肢运动力量等级为0或1，以及2、3和4级或以上。
