Ertekin C, Mungan B, Ertaş M
Department of Neurology, Ege University Faculty of Medicine, Bornova, Izmir, Turkey.
Electromyogr Clin Neurophysiol. 1995 Aug-Sep;35(5):259-71.
Lumbosacral root potentials and sacral spinal cord segmental responses were recorded epidurally in 24 normal adult subjects by tapping the Achilles Tendon with the electronic hammer (mechanical). The averaged responses were also recorded from the same epidural levels after the electrical stimulation of the Posterior Tibial nerve at the popliteal fossa (electrical). While the dorsal and reflexively evoked ventral root responses were easily obtained by the electrical stimulation; by the mechanical stimulation only a late and small ventral root response with two negative deflections could be evoked at the L4-5 or L5-S1 I.V. (intervertebral) epidural levels. The ventral root responses elicited by mechanical stimulation appeared 4.0 msec later than those elicited by the electrical stimulation. This time interval was exactly the same when the latencies of the Soleus reflexes to both stimuli were compared that for the Achilles tendon reflex being 4.0 msec delayed. When the sums of their afferent and the efferent conduction times (to and from Th12-L1 I.V. levels) were extracted from the total conduction times of the Soleus H and Achilles tendon reflex obtained by the EMG recordings, the sacral cord conduction delay was found 1.8 msec for the H-Reflex and 4.1 msec for the Achilles tendon reflex. It was suggested that the twice longer time delay along the sacral cord to Achilles tendon tap might be due to the oligosynaptic linkage of the Achilles tendon reflex or it may result from highly dispersed afferent volley producing a slowly rising wave or excitation that takes longer to reach threshold for the soleus motoneurone discharges.
在24名正常成年受试者中,通过用电子锤(机械方式)轻敲跟腱,在硬膜外记录腰骶神经根电位和骶段脊髓节段反应。在腘窝处对胫后神经进行电刺激(电刺激方式)后,也从相同的硬膜外水平记录平均反应。虽然通过电刺激很容易获得背根和反射性诱发的腹根反应;但通过机械刺激,在L4-5或L5-S1椎间硬膜外水平仅能诱发一个较晚出现的、较小的有两个负向偏转的腹根反应。机械刺激诱发的腹根反应比电刺激诱发的反应晚4.0毫秒出现。当比较比目鱼肌反射对两种刺激的潜伏期时,这个时间间隔完全相同,即跟腱反射延迟4.0毫秒。当从肌电图记录获得的比目鱼肌H反射和跟腱反射的总传导时间中提取它们的传入和传出传导时间总和(至和来自胸12-腰1椎间水平)时,发现骶段脊髓传导延迟在H反射为1.8毫秒,在跟腱反射为4.1毫秒。有人提出,沿骶段脊髓对比目鱼肌叩击的时间延迟长两倍可能是由于跟腱反射的少突触联系,或者可能是由于传入冲动高度分散产生缓慢上升的波或兴奋,需要更长时间才能达到比目鱼运动神经元放电的阈值。