磁场刺激对中风和运动神经元疾病的评定

对上运动神经元及其传导通路的生理功能评定及其临床应用进行研究。以磁场刺激兴奋皮质运动区和脊神经根记录拇短展肌、小指展肌、桡侧腕屈肌和肱二头肌运动诱发电位(MEP)。27名正常受试者和18例患者(10例中风、8例运动神经元疾病)的MEP进行比较,正常人MEP潜伏时、中枢运动神经传导时间(CMCT)结果稳定,波形93.4％为二相,重复性好。但MEP幅度变异大。不同患者和病情使MEP、CMCT发生变化。轻者潜伏时延长、幅度减小、波形重复性差、相数增加和时程变宽,重者MEP完全引不出来,检查结果与临床症状相符合。资料表明用多块肌肉与多种参数的MEP能更准确评定中枢神经及其通道的生理功能。

Diagnosis of Cerebral Vascular Accidents and Motor Nenron Diseaases with Magnetic Stimulation

By using magnetic stimulation of the motor cortex and cervical roots, motor-evoked potentials (MEP) to APB, ADM, FCR and BIC were studied in two groups: 27 healthy subjects and 18 patients with cerebral vascular accidents (CVA) and motor neuron diseases (MND). In the control group, the central motor conduction time (CMCT) was steady and the most wave shape showed 2-phase. MEP was abnormal in the patient group such as prolonged latency, decreased amplitude, no producible, increased phase, extended duration, even absence of response in the serious cases. The relation between MEP and clinical signs was found. This technique could reveal accurately subclinical upper motor neuron involvement and central motor pathway dysfunction in CVA and MND.