酒精性周围神经病的神经电生理特点

为了探讨酒精性周围神经病患者的神经电生理特点,我们对2002年6月至2005年7月在我院临床确诊为酒精性周围神经病13例患者进行神经电生理检测,包括MCV、SCV、EMG及F波,并进行结果分析。1临床资料1.1对象本试验对象是13例临床确诊为酒精性周围神经病患者,其中男12例,女1例,年龄43岁~75岁,平均58.7岁±3.4岁,病程2个月~3年,患者有不同程度的双上肢、双下肢或四肢肢体远端对称性疼痛,感觉异常,感觉减退,其中1例有双足下垂,3例患者有肌萎缩。1.2方法采用牛津公司的OXFORD肌电、诱发电位仪,对13例患者神经进行EMG、SCV、MCV、F波检测。…     

中枢性呼吸衰竭和周围性呼吸衰竭患者机械通气的治疗比较

目的对ICU病房及各科需使用呼吸机治疗的中枢性呼吸衰竭和周围性呼吸衰竭患者使用机械通气治疗的时间和转归进行比较。方法 2003年8月至2005年8月使用有创性呼吸机治疗的全部226例患者分为中枢性呼吸衰竭和周围性呼吸衰竭两组,回顾性分析呼吸机的使用时间及机械通气治疗后的转归。结果中枢性呼吸衰竭患者120例,机械通气的平均时间为（9.1±19.3）d,周围性呼吸衰竭患者106例,机械通气时间为（5.4±10.9）d,P=0.038,前者死亡率为50%,后者死亡率为21.3%,P〈0.005。结论与周围性呼吸衰竭患者相比,中枢性呼吸衰竭患者机械通气时间长、死亡率高。     

一氧化二氮滥用所致周围神经病的神经电生理特点

目的探讨一氧化二氮(N_2O;俗称"笑气")滥用导致的中毒性周围神经病的神经电生理特点。方法回顾性分析2015-07—2018-03期间中日友好医院神经科就诊的15例N_2O滥用导致的周围神经病患者的临床表现,实验室检查,头、颈、胸椎MRI及神经传导检查情况。对照组44例(肢带型肌营养不良23例、脂质沉积病5例、低钾性周期性麻痹8例、视神经脊髓炎8例)行神经传导检查,所检神经的神经传导速度和动作电位波幅均在正常范围,并排除周围神经病变。其中作为正中神经对照23例(29条)、尺神经对照20例(22条)、腓神经对照25例(25条)、胫神经对照25例(32条)。结果 15例患者均临床表现为肢体无力和麻木,下肢肌力下降及感觉损害程度均较上肢为著。其中8例患者MRI显示颈段或颈胸段脊髓后索倒"V"型长T2病灶。与对照组比较,病变组正中神经、尺神经、腓神经、胫神经运动传导速度(MCV)平均值分别下降14.1%、11.1%、18.3%、21.5%;远端复合肌肉动作电位(CMAP)波幅分别下降29.6%、19.5%、63.6%、82.5%(均P0.05);与对照组比较,病变组上、下肢感觉传导速度(SCV)减慢、下肢感觉神经动作电位(SNAP)波幅下降(均P0.05)。7条腓神经和3条胫神经复合肌肉动作电位波幅未测出。2例患者存在运动神经传导阻滞。结论 N_2O滥用可导致神经系统损害,以颈胸段脊髓后索病变和周围神经病变多见。周围神经损害可同时累及运动纤维及感觉纤维,包括轴索变性和脱髓鞘,下肢损害程度较上肢为著。运动轴索较感觉轴索更易受损。受累神经可出现运动传导阻滞。     

前庭中枢性及周围性眩晕患者视频眼震图参数特点分析

目的 探讨前庭中枢性眩晕和前庭周围性眩晕患者视频眼震图（videonystagmography,VNG）的参数特点。 方法 收集2011年3～12月首都医科大学附属北京天坛医院神经内科住院的69例后循环缺血所致前庭中枢性眩晕患者和眩晕会诊中心就诊的108例前庭周围性眩晕（梅尼埃病12例、良性阵发性位置性眩晕96例）患者的临床资料,分析并比较其VNG参数特点和临床特征。 结果 69例前庭中枢性眩晕患者和108例前庭周围性眩晕患者相比,临床特点：男性多见（P<0.001）,年龄更大（P=0.009）,病程更短（P<0.001）,更多出现视物成双（P<0.001）、偏身麻木无力（P<0.001）、言语不利（P<0.001）等症状,较少出现耳蜗症状（P=0.021）,眩晕持续时间更长（P<0.001）,发病多与体位改变无关（P<0.001）;VNG参数特点：视跟踪异常（40.6% vs 0.9%,P<0.001）、定标试验异常（13.0% vs 0.0%,P<0.001）、视动试验异常（10.1% vs 0.0%,P=0.003）、凝视试验异常（10.1% vs 0.0%,P=0.003）、自发性眼震（8.7% vs 0.0%,P=0.007）或位置性眼震（8.7% vs 0.0%,P=0.007）发生比例前庭中枢性眩晕组高于前庭周围性眩晕组;而变位试验阳性（14.5% vs 74.1%,P<0.001）前庭中枢性眩晕组低于前庭周围性眩晕组。 结论 VNG参数特点能客观地反映前庭中枢性眩晕和前庭周围性眩晕患者的眼震情况,结合临床特征有助于前庭系统性眩晕的定位诊断。     

中枢性眩晕临床进展

<正>眩晕是一种运动性或位置性错觉,造成人与周围环境空间关系在大脑皮层中反应失真,产生旋转、倾倒及起伏等感觉,一般人群发生率可达20%~30%~[1]。眩晕多由前庭器官障碍引起,按照部位的不同大致可分为周围性眩晕和中枢性眩晕两大类。中枢性眩晕越占眩晕患者的10.1%~11%,是前庭神经颅内段前庭神经核、核上纤维、内侧纵束、皮质及小脑的前庭代表区病变所致,通常对患者生命造成威     

糖尿病周围神经病电生理特点及与血糖水平的关系

目的研究糖尿病周围神经病的神经电生理特点以及与血糖水平的关系。方法分析2013年3月~2014年3月于本院神经内科住院的108例糖尿病周围神经病患者,测定其正中、尺、胫、腓总神经的运动传导速度(MCV)和复合肌肉动作电位波幅(CMAP),以及正中、尺、腓肠神经、腓浅神经的感觉传导速度(SCV)和感觉神经动作电位波幅(SNAP),比较上、下肢和运动、感觉神经异常情况,分析糖化血红蛋白(HbA1C)、餐后2 h血糖对神经传导速度(NCV)的影响。结果糖尿病患者下肢运动神经病变重于上肢,且差异明显(P<0.05)。感觉神经损害重于运动神经,且差异明显(P     

家族性面神经麻痹的临床及电生理特点

目的:探讨家族性面神经麻痹的临床以及电生理特点。方法:收集周围性面神经麻痹1家系所有患者的临床资料,对先证者及其哥行详细的电生理检查。结果:该家系3代20名成员中共有面神经麻痹患者5例,其中男3例,女2例;右侧面瘫2例,左侧面瘫2例,双侧1例;发病年龄8～31岁;4例多次反复发作;电生理结果示右侧面神经神经性受损;瞬目反射示传出型障碍。结论:面神经麻痹可表现为家族性,临床特点与散发患者类似,电生理无特征性表现。     

周围性眩晕外科治疗的现状及进展

眩晕是临床常见的主诉之一,分为中枢性眩晕以及周围性眩晕,其中前庭周围性眩晕占71%,是主要病因。周围性眩晕的治疗方法主要包括内科治疗、康复治疗和外科治疗,其中,外科治疗是眩晕疾病重要的治疗方法之一。本文就较为常见的周围性眩晕梅尼埃病及良性阵发性位置性眩晕的外科治疗进展做一综述,以期增进对眩晕疾病外科治疗的认识,促进眩晕疾病外科治疗的发展。     

多灶性运动神经病的临床和神经电生理特点及预后

多灶性运动神经病 (ｍｕｌｔｉｆｏｃａｌｍｏｔｏｒｎｅｕｒｏｐａｔｈｙ ,ＭＭＮ)是一种由免疫介导的、主要累及运动纤维的、多灶性运动神经病。 1982年Ｌｅｗｉｓ等首先描述 ,1988年由Ｐｅｓｔｒｏｎｋ等正式命名为ＭＭＮ。该病的主要临床特点为非对称性的、缓慢进展的、以上肢为著的肢体无力 ;电生理表现为持续性节段性运动神经传导阻滞 (ｃｏｎｄｕｃｔｉｏｎｂｌｏｃｋ ,ＣＢ) ;病理上以脱髓鞘为主 ,少数可伴有轻微轴索损害 ,不伴炎性细胞浸润及水肿 ;免疫学检查部分患者抗神经节苷脂抗体 (ＧＭ1)滴度升高 ;对免疫球蛋白及环磷酰胺等…     

Associated central and peripheral demyelination: an electrophysiological study

Summary A case is reported in which retrobulbar neuritis preceded Guillain-Barré syndrome by 4 weeks. The visual evoked potential latencies were prolonged. After peripheral nervous system signs had cleared, median and peroneal somatosensory evoked potentials showed prolonged cervical N13, scalp N20 and L3-scalp conduction times.     

Neuroradiological features of vertigo

Neurological Sciences - The diagnostic pathway in a patient with vertigo starts with the accurate evaluation of medical history followed by a general physical and neurological examination. This...     

Relapsing central and peripheral demyelinating diseases. Unusual pathologic features

We treated a patient who had a demyelinating peripheral neuropathy and a central nervous system inflammatory demyelinating disease. The unusual pathologic feature of dense infiltrates of atypical macrophages was observed in many areas of the brain; otherwise the process had several features in common with either multiple sclerosis or chronic relapsing experimental allergic encephalomyelitis. The illness followed "swine-flu" inoculation; exacerbation followed pneumococcal vaccination.     

Head-shaking tilt suppression: a clinical test to discern central from peripheral causes of vertigo

Journal of Neurology - Tilt suppression refers to both tilting the head away from an Earth vertical axis and a reduction of an induced horizontal nystagmus. This phenomenon of reducing an induced...     

Treatment of vertigo with betahistine and its clinical and electrophysiological evaluation]

Betahistine was administered during 4 weeks to 31 patients with vertigo, divided into 3 groups depending on changes in neurological examination. 1 group--13 patients without abnormalities, 2 group--11 with ischemia vertebrobasilaris, 3 group--7 with lesion of VIII nerves. Significant improvement was obtained in 20 patients (65%), most evident in group 1 (in 11). BAEP examination revealed abnormalities in 12 cases before the treatment and recovery in 4 (33.3%) after 4 weeks of treatment. They were: longer latency of the 1 component (39%), and III and V components mainly in the group with baso-vertebral ischemia. It confirms the supposition that disturbances of microcirculation are responsible for the mechanism of vertigo in these cases.     

Morphological and electrophysiological analysis of the peripheral and central afferent pathways from the clitoris of the cat

Afferent neurons projecting to the clitoris of the cat were identified by WGA-HRP tracing in the S1 and S2 dorsal root ganglia. An average of 433 cells were identified on each side of the animal. 85% and 15% of the labeled cells were located in the S1 and S2 dorsal root ganglia, respectively. The average cross sectional area of clitoral afferent neuron profiles was1, 479±627 μm². Unilateral transection of the pudendal nerve reduced the number of labeled cells to 1% of that on the control side. Central projections of clitoral afferents were identified in the lumbo-sacral segments (L7-S3) of the spinal cord. HRP labeled fibers were located in the marginal zone on the medial side of dorsal horn and extended into the dorsal half of the dorsal gray commissure. Electrophysiological recordings detected axonal volleys in the pudendal nerve and S1 dorsal root in response to electrical stimulation (threshold, 1–4 V) of the clitoral surface. Estimated axonal conduction velocities ar the two sites ranged from 7–27 m/s and 0.6–30 m/s, respectively. Multi-unit recordings from dorsal roots in the lumbo-sacral segments revealed that non-noxious pressure stimulation of the clitoris evoked discharges in the S1 dorsal root. Small increases were also detected in the S2 and L7 roots. Single unit discharges recorded from S1 dorsal roots were activated by electrical stimulation of the clitoral surface at thresholds of 0.6–1.2 V and latencies of 1.5–1.8 ms (estimated conduction velocities of 24–30 m/s). Light constant pressure on the clitoris produced an initial burst of single unit firing (maximum frequencies 170–255 Hz) followed by rapid adaptation and a sustained firing (maximum 40 Hz) which was maintained during the stimulation. Tonic firing increased to an average maximum of 145 Hz at 6–8 g/mm² pressure. These results indicate that the clitoris is innervated by mechano-sensitive myelinated afferent fibers in the pudental nerve which project centrally to the region of the dorsal commissure in the L7-S1 spinal cord.