Kovala T, Tolonen U, Pyhtinen J
Department of Clinical Neurophysiology, Oulu University Central Hospital, Finland.
Electromyogr Clin Neurophysiol. 1993 Sep;33(6):359-67.
Somatosensory potentials evoked by stimulation of the median nerve (median nerve SEPs) were studied in a prospective and sequential series of 40 patients with first supratentorial and nonhaemorrhagic cerebral infarct. In 35 patients the SEPs were recorded three times during the first year after the stroke. The location of the infarcted zone was reflected in the number of detected abnormalities: most patients with infarct changes extending to the gray matter of the Rolandic cortex showed abnormalities in the median nerve SEPs, and all patients with involvement of both precentral and postcentral cortical gray matter had abnormal median nerve SEPs. In the entire patient group when both latency and amplitude abnormalities were included about half (48%) of the patients had abnormal median nerve SEPs a week after the stroke, 39% 2-3 months after the stroke and 29% about one year after the stroke. These changes were not significant. When separately surveying the changes in the numbers of latency and amplitude abnormalities the difference between the first and the third examinations was nearly significant only in the number of latency abnormalities. Furthermore, in the absolute latency and amplitude values, no significant changes could be seen within the first two-three months after the infarct; within the whole one-year follow-up period a nearly significant change was noted between the second and the third examination in only one parameter (P22 peak latency). Thus, the abnormalities in the median nerve SEPs, especially the amplitude abnormalities, were relatively permanent during the one-year period after cerebral infarct.
对40例首次发生幕上非出血性脑梗死的患者进行了前瞻性连续研究，观察刺激正中神经诱发的体感诱发电位（正中神经SEP）。35例患者在卒中后的第一年进行了3次SEP记录。梗死区域的位置反映在检测到的异常数量上：大多数梗死改变延伸至中央前回皮质灰质的患者，正中神经SEP出现异常；所有中央前回和中央后回皮质灰质均受累的患者，正中神经SEP均异常。在整个患者组中，当同时包括潜伏期和波幅异常时，约一半（48%）的患者在卒中后1周正中神经SEP异常，卒中后2 - 3个月为39%，卒中后约1年为29%。这些变化无统计学意义。分别观察潜伏期和波幅异常数量的变化时，第一次和第三次检查之间的差异仅在潜伏期异常数量方面接近有统计学意义。此外，在梗死发生后的最初两三个月内，绝对潜伏期和波幅数值未见明显变化；在整个一年的随访期内，仅在一个参数（P22峰潜伏期）的第二次和第三次检查之间观察到接近有统计学意义的变化。因此，在脑梗死后的一年期间，正中神经SEP异常，尤其是波幅异常，相对持久。
