神经电生理检查对足趾背屈功能障碍的诊断价值

Electrophysiological diagnosis of toe dorsiflexion dysfunction

目的探讨神经电生理检查对无明确外伤史足趾背屈功能障碍的诊断价值。方法对66例（77侧）无明确外伤史且以足趾背屈功能障碍为主诉的患者行神经电生理检测，内容包括：腓肠神经、腓总神经感觉神经传导速度（sensory nerve conduction velocity, SNCV），胫神经、腓总神经运动神经传导速度（motor nerve conduction velocity, MNCV），胫神经、腓总神经、闭孔神经、臀上神经、臀下神经支配肌及椎旁肌的肌电图（electromyogram，EMG）。结果66例中30例（30侧）腓骨小头处腓总神经卡压，2例（2侧）梨状肌出口处坐骨神经卡压，18例（18侧）神经根处受到腰椎间盘压迫，6例（11侧）累及前角运动神经元病变，6例（10侧）为糖尿病引起的周围神经病变，4例（6侧）所检测指标均在正常范围。神经电生理检测所得结果阳性率为93．9％。结论神经电生理检查可以为无明确外伤史引起的足趾背屈功能障碍提供客观的检测指标，对该病的病因诊断具有重要的参考价值。

Objective To investigate the diagnostic value of electrophysiological testing for toe dorsiilexion dysfunction in patients without a history of trauma. Methods The electrophysiological examination was conducted in 66 patients （77 sides） with toe dorsiflexion dysfunctions but without a definite history of trauma. The electrophysiological studies included sensory nerve conduction velocity （SNCV） testing of the sural nerve and common peroneal nerve, motor nerve conduction velocity （MNCV） testing of the tibia1 nerve and common peroneal nerve, dectromyographic （EMG） testing of the muscles innervated by the tibial nerve, the common peroneal nerve, the obturator nerve, the superior gluteal nerve and the inferior gluteal nerve, as well as the paravertebral muscles. Results The electrophysiologic testings revealed common peroneal nerve compression at the fibular head in 30 patients （30 sides）, sciatic nerve compression by its outlet in the piriformis in 2 cases （2 sides）, and nerve root compression by protrusion discs in 18 patients （18 sides）. Six patients （11 sides） involved the anterior horn motor neuron diseases. Diabetic peripheral neuropathy was tested in 6 patients （ 10 sides）. Four cases （6 sides） were normal. The total positive rate of the electrophysiological examination was 93.9%. Conclusion Electrophysiological testing might provide objective evidences for toe dorsitlexion dysfunction to patients without a history of trauma, which is important for the etiological diagnosis of these patients.