Gekht B M, Bzhilianskiĭ M A, Merkulova D M
Zh Nevropatol Psikhiatr Im S S Korsakova. 1987;87(11):1625-9.
The authors have examined the status of sympathetic innervation of the skin structures (by measuring the amplitude and latent period of the appearance of the evoked skin sympathetic potential, ESSP) and the autonomic regulation of the cardiovascular system (by examining the R-R intervals of the ECG at rest and in various functional tests) in 9 patients with the Lambert-Eaton myasthenic syndrome, 10 normal subjects, and in 20 myasthenic patients (a control group). All patients examined before the treatment and 7 patients who were examined following the administration of corticosteroid therapy presented disorders of the latent period and/or the amplitude of ESSP, up to its total absence, as well as signs of cardiac arrhythmias indicative of a marked dysfunction of the cholinergic structures of the peripheral nerves. No correlation has been elicited between the depth of identified vegetative disturbances and the presence of clinical and electromyographic indicators of polyneuropathy. Medicamentous tests serve to confirm the synaptic nature of cholinergic disorders.
作者检测了9例兰伯特-伊顿肌无力综合征患者、10名正常受试者以及20例肌无力患者(对照组)的皮肤结构交感神经支配情况(通过测量诱发皮肤交感神经电位,即ESSP的出现幅度和潜伏期)以及心血管系统的自主调节功能(通过检测静息状态及各种功能测试时心电图的R-R间期)。所有接受检测的患者在治疗前以及7例接受皮质类固醇治疗后接受检测的患者,均出现ESSP潜伏期和/或幅度的紊乱,直至完全消失,同时还出现心律失常迹象,表明外周神经胆碱能结构存在明显功能障碍。所确定的自主神经功能障碍程度与多神经病的临床和肌电图指标之间未发现相关性。药物试验有助于证实胆碱能紊乱的突触性质。