Restuccia D, Di Lazzaro V, Valeriani M, Colosimo C, Tonali P
Department of Neurology, Catholic University, Rome, Italy.
Neurology. 1993 Nov;43(11):2269-75. doi: 10.1212/wnl.43.11.2269.
We studied tibial nerve somatosensory evoked potentials (SEPs) in 22 patients with progressive clinical signs of sensory and motor involvement of the lower limbs. Magnetic resonance imaging (MRI) in 21 patients revealed lesions of the thoracolumbar cord in 18 and of the cauda equina in the remaining three. SEP recordings enabled us to clearly differentiate the response generated by the dorsal horns of the lumbosacral cord from the activity generated in the cauda equina dorsal roots. Neurophysiologic findings strongly correlated with the lesion site demonstrated by the MRI (cauda equina, lumbosacral cord, or thoracic cord immediately above the lumbar enlargement). The N24 cord potential was absent with a normal cauda equina response in 10 of 12 patients with MRI signs of lumbosacral cord lesions. Clinical examination often failed to localize the spinal cord as the lesion site, suggesting pure peripheral involvement in six of the 12 patients with MRI signs of lumbosacral cord lesions.
我们研究了22例有下肢感觉和运动受累临床进行性体征患者的胫神经体感诱发电位（SEP）。21例患者的磁共振成像（MRI）显示，18例胸腰段脊髓有病变，其余3例马尾有病变。SEP记录使我们能够清楚地区分腰骶段脊髓背角产生的反应与马尾背根产生的活动。神经生理学发现与MRI显示的病变部位（马尾、腰骶段脊髓或腰膨大上方的胸段脊髓）密切相关。在12例有腰骶段脊髓病变MRI征象的患者中，10例的马尾反应正常，但N24脊髓电位消失。临床检查常常无法将脊髓定位为病变部位，提示在12例有腰骶段脊髓病变MRI征象的患者中，有6例为单纯周围神经受累。
