André-Obadia N, Garassus P, Mauguière F
Service de neurologie fonctionnelle et d'épileptologie, hôpital neurologique, Lyon.
Neurophysiol Clin. 1996;26(4):236-46. doi: 10.1016/s0987-7053(96)85005-2.
MEPs to transcutaneous magnetic stimulation have been recorded in 43 patients with an intraspinal tumor documented by MRI. The tumor was extramedullary in 18 patients and intramedullary In 25. MEPs were abnormal in 62.8% of patients. There were no significant differences in the rate of MEP abnormalities according to the lesion site or the histological findings, except for meningiomas which showed abnormal MEPs in all eight patients included in this series. The percentage of patients with abnormal MEPs was 9.3% despite the absence of any clinical symptom of central motor pathway dysfunction. Infraclinical MEPs abnormalities were observed in 24% of explored limbs. Median and tibial nerves somatosensory evoked potentials (SEPs) were recorded in 41 patients and showed abnormalities of central conduction or of segmental spinal responses in 65.9% of the cases. When combining data from MEP and SEPs, abnormalities were observed in 70.7% of patients (29/41). Five patients (12.2%) had abnormal MEPs, but normal SEPs, and four other patients (9.8%) had abnormal SEPs, but normal MEPs. This finding suggests that both MEPs and SEPs should be recorded for presurgical evaluation of-intraspinal tumor.
对43例经MRI证实患有椎管内肿瘤的患者记录了经皮磁刺激运动诱发电位(MEP)。18例患者肿瘤位于髓外,25例位于髓内。62.8%的患者MEP异常。根据病变部位或组织学结果,MEP异常率无显著差异,但本系列纳入的所有8例脑膜瘤患者MEP均异常。尽管没有任何中枢运动通路功能障碍的临床症状,但MEP异常的患者比例为9.3%。在24%的被检查肢体中观察到亚临床MEP异常。对41例患者记录了正中神经和胫神经体感诱发电位(SEP),65.9%的病例显示中枢传导或节段性脊髓反应异常。将MEP和SEP的数据合并时,70.7%(29/41)的患者存在异常。5例患者(12.2%)MEP异常但SEP正常,另外4例患者(9.8%)SEP异常但MEP正常。这一发现表明,对于椎管内肿瘤的术前评估,应同时记录MEP和SEP。