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[周围神经损伤的肌电图和神经电图。第一部分]

[Electromyography and electroneurography in peripheral nerve lesions. Part I].

作者信息

Reichel G, Wagner A

出版信息

Zentralbl Neurochir. 1980;41(4):311-8.

PMID:7234230
Abstract

First, the possible forms of the lesion of peripheral nerves are defined in the form of a survey: pressure damage (neurapraxia), axon interruption with maintained envelope structures (axonotmesis) and complete separation of the nerve (neurotmesis). From these, the various prognostic characteristics of a nerve lesion can be derived. An neurological examination is not sufficient for a thorough study of these phenomena. A particularly valuable aid is offered by the neuroelectrodiagnostic methods of electromyography and electroneurography. The technical fundamentals of these are briefly dealt with by the authors and indications are derived from them for the use of the two methods. In case of the open nerve lesion, the methods are used for a demonstration of intact nerve fibres, and, in the later phase, for the proof of returning spontaneous activity as well as the degree of the progress of a reinnervation. As far as chronic pressure damage is concerned, for example in bottle-necks, information regarding the seat and the degree of the nerve damage can be derived. And finally, EMG and ENG permit to make statements about the segmental height of radicular damage; this is necessary in case of plexus damage, but also for the demarcation of distal lesions. In the second part, the combination with the clinical practice and therapy will be dealt with in greater detail.

摘要

首先,以外科检查的形式确定周围神经损伤的可能形式:压迫性损伤(神经失用症)、轴突中断但包膜结构保持完整(轴突断裂)以及神经完全离断(神经断裂)。由此可以得出神经损伤的各种预后特征。仅通过神经学检查不足以全面研究这些现象。肌电图和神经电图等神经电诊断方法提供了特别有价值的帮助。作者简要介绍了这些方法的技术原理,并从中得出了这两种方法的使用指征。对于开放性神经损伤,这些方法用于证明神经纤维的完整性,在后期用于证明自发活动的恢复以及神经再生的进展程度。就慢性压迫性损伤而言,例如在瓶颈部位,可以得出有关神经损伤部位和程度的信息。最后,肌电图和神经电图可以对神经根损伤的节段高度作出判断;这在臂丛神经损伤的情况下是必要的,对于区分远端损伤也很重要。在第二部分中,将更详细地讨论与临床实践和治疗的结合。

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