Urban P P, Schlegel J, Ellrich J, Koehler J, Hopf H C
Neurologische Klinik und Poliklinik der Universitat Mainz, Germany.
J Neurol. 1996 Feb;243(2):171-4. doi: 10.1007/BF02444011.
Phasic inspiratory genioglossus activity prevents pharyngeal airway collapse in healthy subjects during sleep and is diminished or absent in obstructive sleep apnoea syndrome (OSAS), thus leading to pharyngeal obstruction. Case reports of OSAS after pontomedullary lesions indicate that impaired inspiratory genioglossal activity may result from brainstem lesions. We therefore investigated brainstem functions in 18 awake patients with OSAS using brainstem auditory evoked potentials, blink reflex, masseter reflex, masseter inhibitory reflex (in 11 of 18 patients), magnetic evoked potentials of the tongue and electrooculography with vestibular testing. Fifteen of 18 patients showed no electrophysiological abnormalities. One patient had a left pontine and two patients a bilateral pontomesencephalic lesion, although a causal connection with OSAS was not conclusively confirmed. Our results do not support the assumption of a relevant structural brainstem lesion in OSAS patients with normal neurological findings.
在健康受试者睡眠期间，阶段性吸气性颏舌肌活动可防止咽部气道塌陷，而在阻塞性睡眠呼吸暂停综合征（OSAS）患者中这种活动减弱或消失，从而导致咽部阻塞。桥延髓病变后发生OSAS的病例报告表明，吸气性颏舌肌活动受损可能源于脑干病变。因此，我们使用脑干听觉诱发电位、瞬目反射、咬肌反射、咬肌抑制反射（18例患者中的11例）、舌部磁诱发电位以及伴有前庭测试的眼电图，对18例清醒的OSAS患者的脑干功能进行了研究。18例患者中有15例未显示出电生理异常。1例患者有左侧脑桥病变，2例患者有双侧脑桥中脑病变，尽管与OSAS的因果关系未得到最终证实。我们的结果不支持在神经学检查结果正常的OSAS患者中存在相关脑干结构性病变这一假设。
