Buchthal F, Kühl V
J Neurol Neurosurg Psychiatry. 1979 May;42(5):436-51. doi: 10.1136/jnnp.42.5.436.
In three patients sequential studies were performed of sensory and motor conduction after complete section and suture of the median nerve at the wrist and in one patient after partial section of the nerve. The sensory potential evoked by stimuli to digits III and I and recorded proximal to the suture line at the wrist appeared after a delay of three to four months, corresponding to a growth rate of 1.5-2.0 mm per day. From early in the course of regeneration the sensory potential was dispersed in 40 components. In the adult patient the cumulative amplitude increased for two years slowly and thereafter at a two times faster rate. Amplitude and tactile sensibility were normal after 40 months, but the sensory potential was still five times more dispersed than normal. The overall increase in the amplitude of the sensory potentials in children aged 10 and 12 years was three times faster than in adults. In the adults and in the children the maximum sensory conduction velocity was 10-25% of normal. It then increased at 3% per month during the first two years, and thereafter 10 times slower. Forty months after suture in the adults and 13-19 months after suture in the children the conduction velocity had reached 65-75% of normal. The pattern of discrete electrical activity during voluntary effort and the prolonged duration of motor unit potentials indicate persistent enlargement of the reinnervated motor units by peripheral sprouting. The sensory potential recovered five times faster after a compressive nerve lesion than after section and suture as seen in another patient with an affection of the ulnar nerve at the elbow. Normal tactile sensibility was attained 10 times faster than after section and suture. Maximum sensory and motor condution velocity recovered within one year from 60-70% to 80-90% of normal.
对3例患者在腕部正中神经完全离断并缝合后，以及1例患者在神经部分离断后，进行了感觉和运动传导的序贯研究。刺激第Ⅲ和第Ⅰ指所诱发的感觉电位，在腕部缝合线近端记录到，其出现延迟3至4个月，对应每日生长速度为1.5 - 2.0毫米。从再生过程早期起，感觉电位分散为40个成分。在成年患者中，累积波幅缓慢增加两年，此后增速加快两倍。40个月后，波幅和触觉敏感度正常，但感觉电位仍比正常情况分散5倍。10岁和12岁儿童感觉电位波幅的总体增加速度比成年人快3倍。在成年人和儿童中，最大感觉传导速度为正常的10% - 25%。然后在头两年中每月增加3%，此后增速慢10倍。成年患者缝合后40个月，儿童患者缝合后13 - 19个月，传导速度达到正常的65% - 75%。随意用力时离散电活动模式以及运动单位电位持续时间延长，表明再支配的运动单位通过周围芽生持续增大。如另一例肘部尺神经损伤患者所示，压迫性神经损伤后感觉电位恢复速度比离断并缝合后快5倍。正常触觉敏感度的恢复速度比离断并缝合后快10倍。最大感觉和运动传导速度在1年内从正常的60% - 70%恢复到80% - 90%。
