慢性正己烷中毒神经损害的肌电图评价

目的分析慢性正己烷中毒的神经肌电图表现。方法用常规肌电图检查技术对16例慢性正己烷中毒患者进行肌电图神经传导速度检测。结果慢性正己烷中毒患者电生理检查异常率为69%,感觉神经传导速度减慢为29.7%,运动神经传导速度减慢为59.4%,远端潜伏期延长为51.6%。结论慢性正己烷中毒一损害运动神经远端为主,神经损害程度与接触时间长短有关。     

无神经系统症状的糖尿病神经电生理研究(附50例分析)

探讨糖尿病并发周围神经病变的早期诊断问题,我们对50例无神经系统症状的糖尿病患者给以神经电生理检查,和本实验室正常对照组比较,感觉神经传导速度(SCV)减慢24例(48％),其中6例肌电图呈神经原性改变。单神经损害14例,多神经损害10例。以下肢损害为主,合并有上肢神经损害。     

慢性正己烷中毒神经损害的肌电图评价

目的 分析慢性正己烷中毒的神经肌电图表现。方法 用常规肌电图检查技术对16例慢性正己烷中毒患进行肌电图神经传导速度检测。结果 慢性正己烷中毒患电生理检查异常率为69％，感觉神经传导速度减慢为29.7%，运动神经传导速度减慢为59.4%，远端潜伏期延长为51.6%。结论 慢性正己烷中毒一损害运动神经远端为主，神经损害程度与接触时间长短有关。     

无神经系统症状的糖尿病神经电生理研究

探讨糖尿病并发周围神经病变的早期诊断问题,我们对５０例无神经系统症状的糖尿病患者给以神经电生理检查,和本实验室正常对照组比较,感觉神经传导速度（ＳＣＶ）减慢２４例（４８％）,其中６例肌电图呈神经原发改变。单神经损害１４例,多神经损害１０例。以下肢损害为主,合并有上肝神经损害。     

多发性硬化周围神经损伤的电生理学分析

目的报告12例多发性硬化(Ms)病人周围神经电生理检查异常改变，从中证实MS存在周围神经的节段性脱髓鞘病损。方法本组从60例MS中经肌电图检查，发现12例MS病人存在周围神经的异常电生理改变。结果肌电图显示运动传导速度(MCV)减慢的9例，感觉传导速度(SCV)减慢的7例，波形离散的2例；2例测定了F波，潜伏期均延长，12例均有不同程度的纤颤电位。结论MS患者不但出现CNS的脱髓鞘病损，而且部分病人同时存在PNS的脱髓鞘病损。     

脑卒中后肩-手综合征的神经电生理分析

目的通过对临床诊断的脑卒中后肩手综合征(shouder-hand syndrome,SHS)患者神经电生理指标的分析,明确并初步探讨周围神经损伤在SHS发生发展机制中的作用。方法将58例脑卒中患者分为SHS组(39例,伴SHS)和对照组(19例,不伴SHS),分别进行正中神经的针极肌电图(EMG)和神经传导测定。结果针极肌电图检查SHS组39例(100%)均检出插入电位异常,测得纤颤电位和正锐波,异常率明显高于对照组(P＜0．01)。SHS组感觉神经动作电位波幅为(7．77±4．34)mV,复合肌肉动作电位波幅为(10．13±3．15)mV,均较对照组明显降低(P＜0．05),且感觉神经波幅下降程度较运动神经明显(P＜0．05)。结论电生理检查证实SHS的病理生理改变中有周围神经损害因素参与,周围神经损害以轴索变性为主,且感觉神经受累程度重于运动神经。     

进行性腓肌萎缩症的神经电生理学研究

目的 研究进行性腓肌萎缩症患者的肌电图、周围神经传导速度及F反应特点,探讨神经电生理检查对诊断该病的价值.方法 对31例进行性腓肌萎缩症患者的肌电图(EMG)、运动神经传导速度(MCV)、感觉神经传导速度(SCV)及F波进行检测.结果 肌电图异常率90%,运动神经传导速度异常率100%,感觉神经传导速度异常率90%,F波检测异常率34%.结论 神经电生理检查是诊断进行性腓肌萎缩症的可靠方法.     

格林-巴利综合征12例的肌电图观察

我国格林－巴利综合征（GBS）的周围神经损害仍以脱髓鞘为主，从肌电图及尸检提示部分患者存在着轴突损害为主的病理改变犤１犦。现将该院１９９６～２００１年之内曾作过的肌电图的１２例分析如下。１对象与方法１２例患者均经过临床检查、神经电生理测定及脑脊液检查确诊。男８例，女４例，年龄１０～６０岁，平均３３岁。神经肌电图检测：采用丹麦KEYPOINTIV型肌电图仪，按常规操作进性肌电图及神经传导速度、F波测定，观察静息电位、轻用力收缩和重用力收缩时的肌电图变化。２结果１２例患者检测４０条神经，其中２７条神经传导速…     

电生理检查在格林—巴利综合征中的应用

神经电生理检查是格林—巴利综合征(GBS)的重要诊断手段之一。为探讨电生理对GBS的诊断和预后评估的价值，对1995年以来收治的32例确诊为CBS患的电生理检查进行了分析。结果本组电生理改变特点为：运动神经传导速度(MCV)和F波异常率大于感觉神经传导速度(SCV)异常率；电生理动态观察显示，临床症状恢复较电生理恢复快，MCV恢复较SCV恢复快。肌电图(EMC)出现自发电位预后差。     

神经肌电图检查对糖尿病周围神经病变的诊断价值

目的：探讨电生理检查对糖尿病周围神经病变的早期诊断价值。方法：运用肌电诱发电位仪检测200例糖尿病患四肢运动神经传导速度（MCV），感觉神经传导速度（SCV）。结果：临床诊断为糖尿病周围神经病为127例，经肌电图检查增至184例，确诊率由63.5％上升到92.0％；在无症状的73例中经肌电诊断异常为57例，异常率为78.1％。结论：神经肌电图检查是糖尿病周围神经病早期诊断一种有价值的检查手段，可为糖尿病周围神经病临床疗效评估及治疗方案拟定提供重要依据。     

Effects of alcohol on bone, muscle and nerve

The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In peripheral nerves, acute alcohol intoxication may lead to pressure neuropathy and chronic abuse may cause peripheral neuropathy.     

神经电图-肌电图检测对多灶性运动神经病的评估作用

目的:探讨神经电图(ENG)和肌电图(EMG)检查对多灶性运动神经病(multifocalmotorneuropathy,MMN)的诊断价值及康复干预的评估作用。方法:对16例诊断为MMN的患者进行电生理检查,受试者为MMN组16例和正常组16例,分别进行运动神经传导速度(MCV)和感觉神经传导速度(SCV)检查,记录刺激引出的复合肌肉动作电位(compoundmus-cleactionpotentials,CMAP)的波幅、波宽、面积、位相、时限进行对比分析,判定是否有运动神经传导阻滞(conductionblock,CB)或暂时性离散(temporaldispersion,TD)。并有选择性地进行常规肌电图检查。结果:16例患者中均见有一根以上运动神经或至少一根运动神经的一个以上部位出现CB或TD。其中13例双上肢正中神经,尺神经出现CB,3例首发为正中神经尺神经的远端出现CB,随病情进展出现下肢腓深神经CB。仅有两例感觉神经传导速度稍有减慢,波幅略有降低。16例患者神经受累区域以下所支配肌肉肌电图检查见有运动神经源性受损改变。结论:MMN病是一种以远端神经受累为主的不对称性周围神经病,神经电生理检查对诊断和鉴别诊断MMN起重要作用,CB是MMN特征性表现。     

周围神经术前肌电图结果与术中所见的比较研究及误诊原因分析

目的 探讨肌电图(EMG)检查对周围神经损伤的诊断意义，分析误诊的原因。方法 收集2000年1月至2003年4月行手术治疗的周围神经损伤患者63例(69条神经)，按神经损伤特点分为开放性周围神经损伤组、闭合性周围神经损害组、臂丛损伤组和神经修复后再生组，各组患者均于术前进行肌电图检测，并将检测结果与术中所见进行比较、分析。结果 开放性周围神经损伤组术前EMG对神经完全损伤的诊断符合率为73.08％，与术中所见结果比较，差异有统计学意义。闭合性周围神经损害组对受损神经的定性、定位诊断，均在术中得到证实。臂丛损伤组的大体定位正确率达96．30％，完全符合率达70．37％；对臂丛完全根性损伤的检出率为68．52％，与磁共振的检出率(55．56％)相比，差异无统计学意义。神经修复后再生组5条神经，EMG结果与术中所见3条符合，2条不符合。69条神经中，EMG检查完全符合率为71.01％，基本符合率为85．51％，完全不符率为13．04％；假阳性率为4．49％，假阴性率为22．73％。结论 EMG检查对损伤神经的定位、定性诊断及神经修复后再生状况的评价在临床诊治中具有重要的指导意义，但可出现假阳性及假阴性结果，且以运动诱发电位的假阴性为多。术前EMG与磁共振检查相结合，可提高对臂丛神经完全根性损伤的检出率。     

Quantitative ultrasonography in focal neuropathies as compared to clinical and EMG findings.

OBJECTIVE: The aim of this study was to assess the diagnostic value of muscle ultrasonography in focal neuropathies. SUBJECTS AND METHODS: 100 patients suffering from unilateral symptoms or signs on the extremities indicating injuries of nerve roots, plexus, or peripheral nerves were prospectively examined by manual muscle testing (MMT), electromyography (EMG), and quantitative muscle ultrasonography. Muscle thickness and echointensity (gray scale analysis) were measured and compared to the results from 28 control subjects. RESULTS: Ultrasonography was as sensitive as MMT and EMG in detecting muscle involvement. Ultrasonography and EMG were complementary. In 27% of 85 paretic muscles, only one of both techniques revealed pathological findings. Increased echointensity was seen in 82%, atrophy in 31% of pathological muscles. Earliest ultrasonographic abnormalities and pathological spontaneous activity in EMG appeared 10 days after the injury. The inter-observer agreement of ultrasonography was slightly, but significantly lower than that of EMG. CONCLUSION: Muscle ultrasound can visualize anatomical abnormalities such as muscle atrophy and mesenchymal abnormalities in lesions of nerve roots, plexus, and peripheral nerve lesions.     

高频超声诊断周围神经内、外囊肿致神经卡压的临床价值

目的 探讨高频超声在诊断周围神经内、外囊肿导致神经卡压综合征中的临床价值。方法 周围神经囊肿患者27例，使用高频超声扫查病变神经，观察神经内、外囊肿致周围神经损伤声像图表现。并与肌电图、MRI进行比较，以手术术中探查为标准。结果 27例患者超声诊断神经内囊肿12例，主要超声表现神经内条带状囊性结节，上下累及神经范围较长，正常神经束膜受压移位；神经外囊肿15例，主要超声表现为神经卡压变形，近心端及远心端内径明显增粗，束状结构或筛网状结构不清或消失，囊肿与神经分界清晰。与手术术中所见符合的为24例。肌电图结果显示23例为阳性表现，主要为神经传导速度及波幅明显减低。3例患者行MRI检查，检查结果显示神经走行区域囊状信号影，病变与神经分界不清。结论 高频超声可对神经囊肿提供形态学依据，可与肌电图的电生理特点结合，为临床提供更多的影像学支持。     

Spontaneous electromyographic potentials in chronic spinal cord injured patients: relation to spasticity and length of nerve

Nine patients with complete cervical spinal cord injury (SCI) had their vastus medialis, tibialis anterior, and gastrocnemius muscles evaluated with an electromyographic (EMG) examination in the acute (four to eight weeks) and chronic (more than one year) phases. The hypothesis that spontaneous EMG activity changes with time was assessed. During the chronic phase evaluation, a conduction study was performed to rule out peripheral nerve damage, and the amount of reflex activity was assessed on a scale of 0 to 5 (0 = areflexia; 5 = greater than 5 beats of clonus) to estimate the amount of spasticity. Subjects demonstrated normal conduction through the sensory (sural nerve) and/or motor segments of the peroneal and tibial nerves. In the acute phase, each muscle had spontaneous activity with no significant variation between different muscles of the same patient. In the chronic phase, there was a positive correlation between the degree of spontaneous activity in a muscle and the length of its axon (p less than .01) and a negative correlation between the amount of spontaneous activity and the degree of reflex activity (p less than .01). Specifically, the lower motor neuron in the chronic phase of an SCI seems to behave much like an axonopathy where the degree of spontaneous EMG activity is dependent on the length of the axon, with the additional concept that spontaneous activity is inhibited by spasticity.     

经皮神经肌肉电刺激促进周围神经再生的应用价值

背景周围神经损伤后的变性与再生是一个很复杂的病理生理过程,关于电刺激对神经再生恢复的促进作用仍需要探讨.目的比较经皮神经肌肉电刺激治疗促进不同部位周围神经再生的作用与效果.设计以患者为观察对象,病例分析.单位一所医学院附属医院的神经电理室和骨科.对象1999-10/2003-06宁夏医学院附属医院骨科、神经内科门诊及住院的周围神经损伤患者中,选择经临床诊断和肌电图证实的78例周围神经不全损伤患者.方法对入选78例周围神经不全损伤患者采用丹迪Cantata型肌电图仪对,进行经皮神经肌肉电刺激治疗,观察受损周围神经功能恢复情况,并行治疗前、后肌电图对比分析及不同病程治疗后的疗效对比分析.主要观察指标①治疗前后肌电图变化.②神经传导速度变化.③神经功能恢复情况.结果78例臂丛神经、坐骨神经不全损伤者,经1～10个疗程的治疗,53例患者肢体运动、感觉功能恢复正常,18例患者肢体运动、感觉功能明显改善,有效率91%(71/78).治疗后失神经电位,运动神经传导速度,感觉神经传导速度均较治疗前有明显改善.结论经皮神经肌肉电刺激治疗,可促进周围神经的再生,改善受损神经局部血液循环,提高神经肌肉的兴奋性.     

Sonographic evaluation of primary peripheral nerve repair.

OBJECTIVE. This feasibility study was undertaken to define the potential of sonography for the follow-up evaluation of patients with surgical repair after nerve transection and persistent impairment of nerve function. METHODS. Nineteen patients with primary repair of a transected peripheral nerve because of direct trauma or complex fractures were evaluated with sonography. All patients had persistent clinical symptoms and neurologic signs of impaired nerve function. In 11 patients who underwent second operations, the intraoperative findings were correlated with those of sonography. RESULTS. Reliable identification of repaired nerves with sonography was feasible in all patients. However, in some cases, sufficient visualization of the site of nerve coaptation was problematic because of extensive scarring. Sonographic findings included the appearance of partial discontinuity of nerve fascicles, detection of neuromas, and compression of nerves by overlying scars. Surgical correlation with sonographic findings was excellent for neuroma detection; however, definition of nerve continuity on sonography was sometimes impaired by scarring. CONCLUSIONS: Sonography has a high potential for follow-up examinations of peripheral nerves in relation to previous nerve repair in patients with persistent neurologic signs and symptoms of nerve impairment. Sonography may help in decisions for follow-up surgery by identifying lesions such as neuromas in continuity or discontinuous nerve elements--lesions that will possibly benefit from a second look.     

腰椎间盘突出症致坐骨神经痛康复前后肌电图分析

目的 了解腰椎间盘突出症致坐骨神经痛患者康复治疗前后肌电图的差别。方法 31例腰椎间盘突出症患者采用卧床休息、腰围保护,神经阻滞,牵引及运动疗法等系统康复治疗,并在治疗前后进行患肢肌电图检查,对比分析其差异。结果 31例患者治疗4周后患肢胫神经,腓总神经F波的出现率较治疗前显著提高,胫神经H反射弱化及消失的百分比显著降低。其他各项检测指标则无明显变化。结论 腰椎间盘突出症患者经系统的康复治疗后,肌电图反映其近段神经根的传导功能改善,而神经根受损所引起的其他电生理改变并未随临床症状的缓解而消失。     

糖耐量减低患者神经传导速度及交感皮肤反应的研究

目的:观察糖耐量减低(IGT)患者神经传导速度(NCV)和交感皮肤反应(SSR)的变化。方法:对25例IGT患者(IGT组)、32例2型糖尿病(DM)患者(DM组)及18名对照者(对照组)进行一侧肢体NCV检测和四肢SSR检测。结果:与对照组相比,IGT组(除腓神经外)各根神经NCV均有不同程度减慢,但差异均无统计学意义;DM组(除胫神经外)各根神经NCV与对照组相比差异均减慢(P<0.05)。IGT组双下肢SSR起始潜伏期与对照组相比延长(P<0.05);与对照组相比,DM组四肢SSR起始潜伏期显著延长、波幅显著降低(P<0.01)。对照组、IGT组和DM组NCV异常率分别为5.56%、28.00%、65.63%,SSR异常率分别为33.33%、72.00%、93.75%,3组间NCV和SSR异常率均有显著差异(P<0.01)。在IGT和DM组中,SSR异常率均高于NCV异常率,且无症状者亦有一定的NCV和SSR异常率。结论:IGT患者存在临床或亚临床周围神经损害,以小纤维受累为主,大纤维受累较少且局限于感觉纤维;SSR对糖代谢紊乱相关的周围神经损害的早期诊断敏感性优于NCV,但其特异性较差。