运动神经元病的MEP、EMG、NCV与临床

RELATIONSHIP AMONG MEP,EMG,NCV AND CLINIC IN PATIEATS WITH MOTOR NEURON DISEASE

目的:探讨联合应用运动诱发电位(MEP)、肌电图(EMG)和神经传导速度(NCV)对运动神经元病(MND)的诊断和鉴别诊断及分型的价值。方法:对47例 MND 患者做 MEP、EMG及 NCV 检查,EMG 检查三个阶段以上的肌肉,其电生理变化与临床病程、分型进行比较。结果:47例 MND 患者中,MEP 异常34型,占72.3%,以中枢传导时间(CMCT)延长和波幅降低最多,占44.7%;EMG 出现不同电生理变化的神经原性损害依次为运动单位时限增宽93.6%,运动单位减少89.4%,波幅增高74.5%,有纤颤、正相电位68.1%,且随病程延长纤颤、正相电位检出率逐渐降低;运动神经传导速度(MCV)测定,异常7例,占14.9%,感觉神经传导速度(SCV)测定,1条神经轻度减慢,1条波幅降低,异常率占3.3%。结论:MEP、EMG 和 NCV 联合检查,可为MND 的诊断、分型与颈椎病的鉴别诊断,提供客观依据。

Objective:To explore the values of motion evoking potential(MEP),electromyogram (EMG)and nerve conducting velocity(NCV)in diagnosis,differential diagnosis and typing of motor neuron dis- ease(MND).Methods:We examined MEP,EMG and NCV of 47 MND patients,and compared their electro- physiological changes,clinical course and type of illness.More than three section muscles of a patient were exam- ined by EMG.Results:In 47 patients with MND 34 cases had MEP abnormity(72.3%),and 44.7% of them showed prolong of central conolucting times(CMCT)and decrease of wave amplitudes.Electrophysiological changes of neurogenic damages on EMG were prolongation of motion unit timelimited(93.6%),decrease of mo- tion unit(89.4%),increase of wave amplitudes(74.5%),fibrillation and positive potential(68.1%)and the positire rate decreased with prolongation of course of disease.In 7 patients(14.9%),motor nerve conducting ve- locity(MCV)was abnormal,sensory nerve conducting velocity(SCV)slowed slightly in a nerve and wave am- plitude decreased in another one.Conclusions:Using MEP,EMG and NCV jointly could provide objective evi- dence of diagnosis and type of MND and differential diagnosis of MND with cervical spondylopathy.