Emeryk-Szajewska B, Kostera-Pruszczyk A, Rowińska-Marcińska K, Karwańska A
Kliniki Neurologicznej AM, Warszawie.
Neurol Neurochir Pol. 1998 Jan-Feb;32(1):39-49.
Our material comparises 105 patients (62 men and 43 women) aged 26-73 years with amyotrophic lateral sclerosis (ALS). EMG examination confirmed the diagnosis of multilevel lesion of spinal motor neurons. Clinically, 94 of them had classical ALS, 3 had primary bulbar palsy (PBP), 6 had primary motor spinal atrophy (PSMA), and 2 had primary lateral sclerosis (PLS). Disease duration was 18.1 month, on the average, ranging from 2-60 months. In all patients motor and sensory nerve conduction was studied in median, peroneal and sural nerves. Conduction velocity, distal latency, F-wave latency of motor nerves, amplitude of M response and of sensory potentials were evaluated. Abnormalities were found most often in the motor fibres of median nerve: lowering of the M response amplitude in 44% of nerves studied, slowing of conduction velocity and elongation of distal latency in ca. 30%, elongation of F-wave latency in 27%. In the peroneal nerve the changes were less frequent: 38%, 21%, and 3%, respectively. They were also less marked. In the sensory fibres of median nerve slowing of conduction velocity was found in 25% of nerves, in sural nerve in 11%. Some slight decrease of amplitude of sensory potentials was seen in those nerves. The results obtained indicate a possibility of peripheral nerve lesion in the course of ALS which must be remembered in clinical diagnosing.
我们的研究材料包括105例年龄在26 - 73岁之间的肌萎缩侧索硬化症(ALS)患者(62名男性和43名女性)。肌电图检查证实为脊髓运动神经元的多节段病变。临床上,其中94例患有典型的ALS,3例患有原发性延髓麻痹(PBP),6例患有原发性脊髓性肌萎缩(PSMA),2例患有原发性侧索硬化(PLS)。疾病持续时间平均为18.1个月,范围为2 - 60个月。对所有患者的正中神经、腓总神经和腓肠神经进行了运动和感觉神经传导研究。评估了运动神经的传导速度、远端潜伏期、F波潜伏期、M反应幅度以及感觉电位幅度。在正中神经的运动纤维中最常发现异常:在所研究的神经中,44%的神经M反应幅度降低,约30%的神经传导速度减慢和远端潜伏期延长,27%的神经F波潜伏期延长。在腓总神经中,变化频率较低,分别为38%、21%和3%。变化也不那么明显。在正中神经的感觉纤维中,25%的神经传导速度减慢,在腓肠神经中为11%。在这些神经中可见感觉电位幅度略有下降。所获得的结果表明,在ALS病程中可能存在周围神经病变,这在临床诊断中必须予以考虑。