Triggs W J, Berić A
Division of Restorative Neurology and Human Neurobiology, Baylor College of Medicine, Houston, Texas.
Muscle Nerve. 1993 May;16(5):492-7. doi: 10.1002/mus.880160510.
We studied a previously healthy 25-year-old woman with the anterior spinal artery syndrome, a rare thoracocervical myelopathy with multiple potential etiologies. Quantitative and clinical sensory examination showed dissociated loss of pin-prick and temperature discrimination below the level of the lesion, with normal light touch, vibratory, and position sense. Magnetic resonance imaging was consistent with cervical spinal cord infarction. Median SEPs showed normal Erb's potential with absent spinal N13- and normal scalp N20- latency. Tibial SEPs showed normal lumbosacral responses and normal scalp P30- latency. Both median and tibial nerve stimulation produced cortical responses of unusually large amplitude (median 38 microV, tibial 17 microV). We hypothesize that large SEP amplitudes in this patient resulted from loss of anterolateral inhibitory influences on the dorsal column-medial lemniscal system.
我们研究了一名既往健康的25岁女性，她患有脊髓前动脉综合征，这是一种罕见的胸颈段脊髓病，有多种潜在病因。定量和临床感觉检查显示，在病变水平以下存在针刺觉和温度觉分离性丧失，而轻触觉、振动觉和位置觉正常。磁共振成像与颈段脊髓梗死相符。正中神经体感诱发电位显示Erb电位正常，但脊髓N13潜伏期缺失，头皮N20潜伏期正常。胫神经体感诱发电位显示腰骶部反应正常，头皮P30潜伏期正常。正中神经和胫神经刺激均产生了异常大的皮层反应（正中神经38微伏，胫神经17微伏）。我们推测，该患者体感诱发电位幅度增大是由于脊髓丘脑侧束对薄束-内侧丘系系统的前外侧抑制作用丧失所致。
