Debbarma Aparna, Chowdhary Sarita, Bhagat Priyanka
Department of Physiology, Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Agartala, Tripura, India.
Department of Pediatrics Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Int J Appl Basic Med Res. 2023 Apr-Jun;13(2):77-82. doi: 10.4103/ijabmr.ijabmr_484_22. Epub 2023 Jul 17.
The study aimed to assess the electrophysiological parameters (Hofmann reflex [H-reflex] and motor nerve conduction velocity [MNCV]) on children's upper and lower limbs with lumbosacral meningomyelocele (MMC) and age-matched control to see the effect of the MMC on the cervical segment of the spinal cord.
The present study was performed on infants with lumbosacral MMC. Twenty-five infants were examined with a mean age of 50 days of either sex. Out of them, 13 infants were in control and the remaining 12 were diagnosed with MMC. The H-reflex parameter and MNCV were recorded in these children's right upper and lower limbs.
H-reflex was elicited in all the control group babies. In MMC, the H-reflex was elicited in the upper limbs. However, H-reflex was not elicited in the lower limbs of a few MMC babies. The upper limb's H-reflex parameters and conduction velocity were significantly higher than those corresponding lower limbs in control babies. In MMC, where the H-reflex was elicited, such differences in the lower and upper limbs were not observed. However, the values of MNCV in the upper limb (right median nerve) were significantly less, and the values of Hmax in the lower limb (soleus muscle) were significantly more in MMC babies than in the control group.
The values of electrophysiological parameters were higher in the upper limbs as compared to the corresponding lower limbs in control. These values were not altered in the upper limbs than those corresponding lower limbs of MMC, suggesting that motor function development was impaired/delayed in the spinal segment cranial to MMC lesion, and motor impairment in MMC children is mostly a result of upper motor neuron dysfunction.
本研究旨在评估患有腰骶部脊髓脊膜膨出（MMC）的儿童上下肢的电生理参数（霍夫曼反射[H反射]和运动神经传导速度[MNCV]），并与年龄匹配的对照组进行比较，以观察MMC对脊髓颈段的影响。
本研究对患有腰骶部MMC的婴儿进行。共检查了25名婴儿，平均年龄50天，性别不限。其中，13名婴儿为对照组，其余12名被诊断为MMC。记录了这些儿童右上肢和下肢的H反射参数和MNCV。
所有对照组婴儿均引出H反射。在MMC组中，上肢引出了H反射。然而，一些MMC婴儿的下肢未引出H反射。对照组婴儿上肢的H反射参数和传导速度显著高于相应的下肢。在引出H反射的MMC患儿中，未观察到上下肢的这种差异。然而，MMC患儿上肢（右正中神经）的MNCV值显著较低，下肢（比目鱼肌）的Hmax值显著高于对照组。
对照组中，上肢的电生理参数值高于相应的下肢。MMC患儿上肢的这些值与相应下肢相比没有变化，这表明MMC病变上方脊髓节段的运动功能发育受损/延迟，MMC患儿的运动障碍主要是上运动神经元功能障碍的结果。
