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[畸形性脊髓空洞症的临床缺陷、运动和感觉诱发电位与MRI影像学表现之间的相关性。27例病例]

[Correlations between clinical deficits, motor and sensory evoked potentials and radiologic aspects of MRI in malformative syringomyelia. 27 Cases].

作者信息

Emery E, Hort-Legrand C, Hurth M, Metral S

机构信息

Service de neurochirurgie, hôpital Beaujon, Clichy, France.

出版信息

Neurophysiol Clin. 1998 Feb;28(1):56-72. doi: 10.1016/s0987-7053(97)89578-0.

Abstract

Twenty-seven patients (15 males, 12 females, age range: 16-66 years) were admitted for malformative syringomyelia diagnosed on MRI with measures of syrinx extending and transverse diameter. Posterior tibial somatosensory evoked potentials (PT SEP), median (M SEP), trigeminal (V3 SEP), brain stem auditory evoked potentials (BEAP), cortical and cervical motor evoked potentials (MEP) were correlated with clinical and radiological findings. SEP abnormalities were not correlated with the duration of symptoms. PT SEP proved to be more sensitive than M SEP. MEP abnormalities were very frequent (87% of the cases), even without clinical motor deficits. Trigeminal SEP were more sensitive than BEAP which were not related to the presence of associated cranio-vertebral abnormalities. We found no significative relationship between clinical and radiological results. Moreover, there was a positive relationship between electrophysiological and radiological results: abnormal trigeminal SEP were detected in 85% of the patients with high cervical syringomyelia. In all cases, trigeminal SEP and MEP should be done in association with M and PT SEP as both of them detect subclinical evidence of spinal cord dysfunction in syringomyelia.

摘要

27例患者(男性15例,女性12例,年龄范围:16 - 66岁)因MRI诊断为畸形性脊髓空洞症入院,测量了空洞的上下径和横径。将胫后体感诱发电位(PT SEP)、正中神经体感诱发电位(M SEP)、三叉神经诱发电位(V3 SEP)、脑干听觉诱发电位(BEAP)、皮层及颈段运动诱发电位(MEP)与临床和影像学检查结果进行相关性分析。SEP异常与症状持续时间无关。PT SEP比M SEP更敏感。MEP异常非常常见(87%的病例),即使无临床运动功能缺损。三叉神经SEP比BEAP更敏感,BEAP与合并的颅颈交界区异常无关。我们发现临床和影像学检查结果之间无显著相关性。此外,电生理和影像学检查结果之间存在正相关:85%的高位颈髓空洞症患者检测到三叉神经SEP异常。在所有病例中,三叉神经SEP和MEP应与M SEP和PT SEP联合进行,因为它们都能检测到脊髓空洞症患者脊髓功能障碍的亚临床证据。

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