Stöhr M, Riffel B, Buettner U W
EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1981 Dec;12(4):195-7.
Simultaneous recording of SEP from the contralateral scalp, the lower neck (C 7) and Erb's point following median or ulnar nerve stimulation may be helpful in the localisation of lesions of the brachial plexus and associated spinal roots. In lesions proximal to the dorsal root ganglia, the potential recorded from Erb's point (EP), as well as the first component of the neck-SEP ("NSEP 1", "N 9") are normal, whereas the following components of the cervical response ("NSEP 2 + 3", "N 11 + N 13") are reduced or absent, depending on the severity of the functional impairment (Fig. 1). In lesions distal to the ganglia the EP-potential shows a significant reduction in amplitude as compared to the normal side. The neck- and scale-SEP are less attenuated or even normal in this condition, because of the phenomenon of synaptic amplification (Fig. 2). Combined lesions of the brachial plexus and cervical roots, which especially occur in traumatic injuries are characterized by an attenuation of the EP-potential and a relatively larger attenuation or an absence of the neck-SEP (N 13) (Fig. 3). SEP examination may therefore be valuable in estimating the degree of involvement distal and proximal to the dorsal root ganglia.
在正中神经或尺神经刺激后,同时记录对侧头皮、下颈部(C7)和臂丛点的体感诱发电位(SEP),可能有助于臂丛神经及其相关脊神经根病变的定位。在背根神经节近端的病变中,从臂丛点(EP)记录的电位以及颈部SEP的第一个成分(“NSEP 1”,“N9”)是正常的,而颈部反应的后续成分(“NSEP 2 + 3”,“N 11 + N 13”)则根据功能损害的严重程度而降低或消失(图1)。在神经节远端的病变中,与正常侧相比,EP电位的振幅显著降低。由于突触放大现象,在这种情况下,颈部和头皮SEP减弱较少甚至正常(图2)。臂丛神经和颈神经根的联合病变,尤其发生在创伤性损伤中,其特征是EP电位减弱,颈部SEP(N 13)减弱相对较大或消失(图3)。因此,SEP检查在评估背根神经节远端和近端的受累程度方面可能是有价值的。