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腓骨肌萎缩症和弗里德赖希遗传性共济失调中外周和中枢躯体感觉通路的研究(作者译)

[Investigations of peripheral and central somatosensory pathways in peroneal muscular atrophy and Friedreich's heredoataxia (author's transl)].

作者信息

Sauer M

出版信息

Arch Psychiatr Nervenkr (1970). 1980;228(3):223-42. doi: 10.1007/BF00342348.

Abstract

Twenty-eight patients with peroneal muscular atrophy (PMA) have been investigated. Eighteen of them were affected by the Charcot-Marie-Tooth disease and three by Dejerine-Sottas disease. In these 21 cases the nerve conduction velocity (NCV) was decreased. Four patients presented the neuronal type of PMA, two cases showed sensory neuropathy of the neuronal type with ophthalmoplegia, and one case, PMA with ataxia, i.e., a myatrophic ataxia. In the neuronal type of PMA, including both cases with ophthalmophegia, the amplitudes of the sensory nerve action potentials were decreased, and the NCV was normal to slightly subnormal. In myatrophic ataxia NCV was decreased. In all cases with reduced NCV, the latencies of the spinal-evoked potentials (spinEP) and somatosensory-evoked potentials (ssEP) were prolonged. In the neuronal type of PMA, these latencies were normal. The central latencies (from thoracic and cervical level) were normal in all 28 patients with PMA of different types. Seventeen patients with Friedreich's heredoatazia have been investigated. In all except two cases, NCV was normal. The sensory nerve-action potentials markedly decreased or disappeared in all cases. The peripheral neurographic picture, accordingly, corresponds to that of patients with the neuronal type of PMA. The latencies of spinEP were normal. All patients with Friedreich's heredoatazia, however, showed prolonged latencies of ssEP. Calculating the central latencies as the difference between ssEP and spinEP latencies (cervical and thoracic) confirms that this is due to a slowing of the conduction velocity via the spinobulbar tracts.

摘要

对28例腓骨肌萎缩症(PMA)患者进行了研究。其中18例患有夏科-马里-图思病,3例患有德热里纳-索塔斯病。在这21例中,神经传导速度(NCV)降低。4例表现为神经元型PMA,2例表现为伴有眼肌麻痹的神经元型感觉神经病,1例表现为伴有共济失调的PMA,即肌萎缩性共济失调。在神经元型PMA中,包括两例伴有眼肌麻痹的病例,感觉神经动作电位的波幅降低,NCV正常至略低于正常。在肌萎缩性共济失调中,NCV降低。在所有NCV降低的病例中,脊髓诱发电位(spinEP)和体感诱发电位(ssEP)的潜伏期延长。在神经元型PMA中,这些潜伏期正常。在所有28例不同类型PMA患者中,中枢潜伏期(来自胸段和颈段水平)正常。对17例弗里德赖希遗传性共济失调患者进行了研究。除2例以外,所有患者的NCV均正常。在所有病例中,感觉神经动作电位均明显降低或消失。因此,周围神经图像与神经元型PMA患者的图像一致。spinEP的潜伏期正常。然而,所有弗里德赖希遗传性共济失调患者的ssEP潜伏期均延长。通过计算ssEP和spinEP潜伏期(颈段和胸段)之间的差异来确定中枢潜伏期,证实这是由于通过脊髓延髓束的传导速度减慢所致。

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