Bouche P
Service d'explorations fonctionnelles-neurologie, Hôpital de la Salpêtrière, Paris, France.
Neurophysiol Clin. 1988 Apr;18(2):101-22. doi: 10.1016/s0987-7053(88)80116-3.
In many cases, one encounters great difficulties in finding causes of polyneuropathies among some 100 etiologies. However, in current practice, the diagnostic span is not so large. At this point, it is usual to get some aid from electrophysiologic tests in order to determine the nature of the peripheral nerve disorder. Examination with needle electrodes is mainly useful to detect fibrillation potentials or positive sharp waves which are indicative of an acute or subacute axonal neuropathy in which the process of degeneration is more important than the capacities of regeneration. Studies of sensory and motor nerve conduction velocities is of a more important utility to separate the different types of peripheral neuropathies: axonopathies in which nerve conduction velocities are normal or slightly decreased but in which muscular evoked potentials and sensory potentials are reduced, myelin disorders in which nerve conduction velocities are markedly decreased and in which finding of conduction blocks allows to individualize two forms, motor and sensory neuronopathies, where the pure lesion of the motor or sensory cell bodies correlate with the normality of sensory and motor pathways respectively.
在许多情况下,要在约100种病因中找出多发性神经病的病因极为困难。然而,在当前的临床实践中,诊断范围并没有那么大。此时,通常会借助电生理检查来确定周围神经疾病的性质。针电极检查主要用于检测纤颤电位或正锐波,这些电位表明存在急性或亚急性轴索性神经病,其中神经变性过程比再生能力更为重要。感觉和运动神经传导速度的研究对于区分不同类型的周围神经病更为重要:轴索性神经病中神经传导速度正常或略有下降,但肌肉诱发电位和感觉电位降低;脱髓鞘疾病中神经传导速度明显下降,且传导阻滞的发现有助于区分两种形式,即运动和感觉神经元病,其中运动或感觉细胞体的单纯病变分别与感觉和运动通路的正常情况相关。