单神经病中肌电图、复合肌肉动作电位和感觉神经动作电位幅度降低与轴突丢失的相关性。

Correlation of EMG, CMAP and SNAP amplitude decrease in mononeuropathies with axonal loss.

作者信息

Wu P B, Gussner C G, Date E S

机构信息

Department of Functional Restoration, Stanford University Medical Center, USA.

出版信息

Electromyogr Clin Neurophysiol. 1996 Oct-Nov;36(7):405-9.

PMID:8957165

Abstract

We retrospectively reviewed electrodiagnostic studies from 1983 to 1994 and found 48 patients who met our criteria for mononeuropathy with axonal loss (40 ulnar, 4 peroneal, 4 radial). Appropriate diagnostic criteria required bilateral studies with a normal contralateral, sensory nerve action potential (SNAP) amplitude decrease of > 50% compared to contralateral, and/or distal compound muscle action potential (CMAP) amplitude decrease of > 40% compared to contralateral, and/or presence of denervation potentials; and sufficient electrodiagnostic investigation to rule out peripheral polyneuropathy. We conclude that in the electrodiagnosis of mononeuropathy with axonal loss: 1) a significant quantitative correlation between CMAP and SNAP amplitude percentage decrease does not exist (r = 0.274, p = 0.06), 2) SNAP amplitude percentage decrease [75.3 +/- 31.8%] is greater than CMAP amplitude percentage decrease [43.9 +/- 31.3%] (paired t-test, p = 0.0001), and 3) CMAP amplitude decrease is positively correlated with the presence of denervation potentials (Xtrend2 = 6.22, p = 0.013).

摘要

我们回顾性分析了1983年至1994年的电诊断研究，发现48例患者符合我们关于轴索性单神经病的标准（40例尺神经、4例腓总神经、4例桡神经）。合适的诊断标准要求进行双侧检查，对侧正常，感觉神经动作电位（SNAP）波幅较对侧降低>50%，和/或复合肌肉动作电位（CMAP）波幅较对侧降低>40%，和/或存在失神经电位；并且要有足够的电诊断检查以排除周围性多发性神经病。我们得出结论，在轴索性单神经病的电诊断中：1）CMAP与SNAP波幅降低百分比之间不存在显著的定量相关性（r = 0.274，p = 0.06），2）SNAP波幅降低百分比[75.3±31.8%]大于CMAP波幅降低百分比[43.9±31.3%]（配对t检验，p = 0.0001），3）CMAP波幅降低与失神经电位的存在呈正相关（Xtrend2 = 6.22，p = 0.013）。