Voulgaris A N, Constantinidis T S
X-Ray Department, University Hospital Areteion, Athens, Greece.
Electromyogr Clin Neurophysiol. 1996 Oct-Nov;36(7):387-93.
F-wave persistence of the deep peroneal nerve was studied in 41 patients with L5-S1 compressive root lesion (22 with radicular pain (RP) and 19 with motor and/or sensory (MS) signs), and in 26 normal control subjects. We used specific conditions, i.e., surface electrodes, stronger stimulus and facilitating maneuver in order to enhance the frequency of F-response appearance. EMG and nerve conduction studies were done F-latency was also measured on both sides of the patients. In the affected sides, both RP and MS, F-persistence's mean value was 56.1 and 31.0 respectively, which was significantly (p < 0.01) lower than controls (mean 83.2), and showed a significant correlation with the extensor digitorum brevis maximal interference pattern. These findings possibly reflect demyelination and/or axonal damage of lower motoneuron. Reduced F-persistence was found in 22 selected patient sides with unequivocal dorsal root damage only (mean 56.7, p < 0.01). This finding could be the result of a reduced lower motoneuron excitability because of the disruption of the circuit retaining the muscle tone. The diagnostic utility of F-persistence, F-latency and EMG was also tested. EMG and F-persistence were found statistically equal while F-persistence was found with a significant preponderance in comparison with F-latency. Finally, EMG was found more sensitive than F-latency in the patient sides with neurologic deficits.
对41例L5 - S1神经根受压病变患者(22例有神经根性疼痛(RP),19例有运动和/或感觉(MS)体征)以及26例正常对照者的腓深神经F波持续性进行了研究。我们采用了特定条件,即表面电极、更强的刺激和易化手法,以提高F反应出现的频率。进行了肌电图(EMG)和神经传导研究,还测量了患者双侧的F波潜伏期。在患侧,无论是RP组还是MS组,F波持续性的平均值分别为56.1和31.0,显著低于对照组(平均值83.2,p < 0.01),并且与趾短伸肌最大干扰型呈显著相关。这些发现可能反映了下运动神经元的脱髓鞘和/或轴突损伤。在仅明确有背根损伤的22例选定患者的患侧发现F波持续性降低(平均值56.7,p < 0.01)。这一发现可能是由于维持肌肉张力的回路中断导致下运动神经元兴奋性降低的结果。还测试了F波持续性、F波潜伏期和EMG的诊断效用。发现EMG和F波持续性在统计学上相当,而F波持续性与F波潜伏期相比具有显著优势。最后,发现在有神经功能缺损的患者患侧,EMG比F波潜伏期更敏感。