Bischoff C, Stålberg E, Falck B, Puksa L
Department of Neurology and Clinical Neurophysiology, Technical University Muenchen, Germany.
Electroencephalogr Clin Neurophysiol. 1996 Dec;101(6):528-33. doi: 10.1016/s0013-4694(96)96553-4.
The occurrence of A-waves during routine F-wave studies was investigated in 556 consecutive patients referred to the Department of Clinical Neurophysiology at the University Hospital in Uppsala for various neuromuscular disorders. Altogether, 2367 nerves in the upper and lower extremities were studied. An A-wave, with a nearly constant latency and a uniform shape on consecutive stimulations, could be recorded in 184 nerves (7.8%) out of 124 patients (22.3%). More than 50% of patients with A-waves had various types of polyneuropathies. Of all patients with polyneuropathy, 65% had at least one nerve with A-waves. A-waves occurred somewhat less frequently in patients with radiculopathies. In other proximal local nerve lesions they were found less often and only exceptionally in patients with distal nerve lesions. A-waves were present in 6 out of 10 patients with motor neurone diseases. There was no correlation between the number of A-waves found in one nerve or the number of nerves in a given patient with A-waves and the aetiology or severity of the underlying disease. A-waves were found in 11 patients referred for various neurological symptoms in whom other neurophysiological findings were normal. This might be interpreted as an early sign of underlying disease because in 100 healthy controls no A-waves could be elicited, with the exception of 3 subjects who had A-waves in the abductor hallucis muscle when the tibial nerve was stimulated. We conclude that the appearance of A-waves should be considered a sign of either a local nerve lesion or a generalised neuropathy in all other nerves except for the tibial nerve.
在乌普萨拉大学医院临床神经生理学系，对556例因各种神经肌肉疾病前来就诊的连续患者进行了常规F波研究中A波出现情况的调查。共研究了上下肢的2367条神经。在124例患者（22.3%）的184条神经（7.8%）中，可记录到A波，其在连续刺激时潜伏期几乎恒定且形态一致。超过50%有A波的患者患有各种类型的多发性神经病。在所有患有多发性神经病的患者中，65%至少有一条神经出现A波。A波在神经根病患者中出现的频率略低。在其他近端局部神经病变患者中较少发现A波，而在远端神经病变患者中仅偶尔发现。10例运动神经元病患者中有6例出现A波。在一条神经中发现的A波数量或某一患者中有A波的神经数量与潜在疾病的病因或严重程度之间无相关性。在11例因各种神经症状前来就诊且其他神经生理学检查结果正常的患者中发现了A波。这可能被解释为潜在疾病的早期迹象，因为在100名健康对照者中，除3名在刺激胫神经时拇展肌出现A波的受试者外，未引出A波。我们得出结论，除胫神经外，在所有其他神经中，A波的出现应被视为局部神经病变或全身性神经病的一个迹象。
