重症肌无力20例患者VEP、SEP、BAEP的变化及临床意义

Changes in the VEP,SEP and BAEP in patients with myasthenis gravis

目的:比较重症肌无力(MG)患者模式翻转视觉诱发电位(VEP)、体感诱发电位(SEP) 及脑干听觉诱发电位(BAEP)3种诱发电位的变化。方法:测定20例新诊断的MG患者和50例正常人的VEP、SEP及BAEP。结果:与正常人比较,VEP 6例(30％)异常,其中5例双侧和1例单侧P100潜伏期延长,波幅降低;SEP 4例(20％)异常,其中3例双侧和1例单侧N13-N20波间期延长,波幅降低; BAEP 9例(45％)异常,其中7例双侧和2例单侧的Ⅲ-Ⅴ和Ⅰ-Ⅴ波间期延长,Ⅲ、Ⅴ波波幅减低。结论:有部分MG患者的VEP、SEP及BAEP有明显的变化,提示他们可能存在中枢神经系统胆碱能通路不同程度受损害,并且这三种诱发电位可能对胆碱能传递受损程度的判断有临床价值。

Objective;To study the changes of pattern reversal visual evoked potential（VEP） ,somatosensory evoked potential（SEP） and brainstem auditory evoked potential（BAEP） in patients with myas thenia gravis（MG）. Methods： VEP,SEP and BAEP were recorded in 20 patients with MG and 50 normal controls included. Results： As compared with the normal group, VEP, SEP and BAEP were abnormal unilaterally or bilaterally in the patients. The prolongation of the latency and the decrease of the amplitude of VEP P100 were found in 5 patients bilaterally and 1 patients unilaterally. The prolongation of latency and the decrease of the amplitude of SEP N13 N20 were found in 3 patients bilaterally and 1 patient unilat-erally. The prolongation of interpeak latency and the decrease of the amplitude of BAEP Ⅰ-Ⅴ and Ⅲ-Ⅴ were found in 7 patients bilaterally and 2 patients unilaterally. Conclusions： There were significant changes of VEP,SEP and BAEP in some patients with MG. The results indicate that VEP, SEP and BA EP were valuable in investigating the possibility of impaired eholinergic transmission in the central nerv ous system （CNS）of patients with MG,suggesting damages of the CNS in visual,somatosensory and au ditory pathways of some patients with MG to difficult extent.