Sugioka H, Tsuyama N, Hara T, Nagano A, Tachibana S, Ochiai N
Arch Orthop Trauma Surg (1978). 1982;99(3):143-51. doi: 10.1007/BF00379201.
With the intention of estimating the extent and site of damage in brachial plexus injuries which involve close to the root outlet and also the distal portion, cortical somatosensory evoked potentials (SEP) were recorded in 21 patients by directly stimulating the exposed brachial plexus. In 38 avulsed nerve roots which showed positive sensory action potentials (SNAP)/nerve action potentials (NAP) in their peripheral part, 15 roots (nine patients) were apparently in continuity and confirmed as root avulsion injury by the absence of cortical SEP. However, 11 roots (ten patients) which showed neither SNAP nor SEP would suggest either extensive lesions involving root and more distal segment or a combination of root avulsion and postganglionic injury. Fourteen patients who showed a positive Tinel's sign had at least one root with a postganglionic type lesion, but cortical SEP evoked by stimulation of the most proximal root zone sometimes revealed a reduced amplitude and prolonged latency. This would indicate the retrograde extension of damage. To confirm the extent and degree of the nerve lesions in brachial plexus injuries, an intraoperative SEP and NAP recording is very useful, practical, and also indispensable.
为了评估臂丛神经损伤中接近神经根出口处及远端部分的损伤范围和部位，通过直接刺激暴露的臂丛神经，对21例患者进行了皮质体感诱发电位（SEP）记录。在38例其周围部分显示有阳性感觉动作电位（SNAP）/神经动作电位（NAP）的撕脱神经根中，15根（9例患者）明显连续，因无皮质SEP而被确认为根撕脱伤。然而，11根（10例患者）既未显示SNAP也未显示SEP，提示可能存在累及神经根和更远端节段的广泛损伤，或根撕脱和节后损伤的组合。14例出现Tinel征阳性的患者至少有一根存在节后型损伤，但刺激最近端神经根区诱发的皮质SEP有时显示波幅降低和潜伏期延长。这表明损伤有逆行扩展。为了确定臂丛神经损伤中神经病变的范围和程度，术中SEP和NAP记录非常有用、实用且必不可少。
