痛觉诱发电位示肌萎缩侧索硬化患者痛觉通路正常

The study on pain evoked potentials in patients with amyotrophic lateral sclerosis

目的研究肌萎缩侧索硬化患者痛觉诱发电位的特点，评估其痛觉通路的传导。方法肌萎缩侧索硬化患者60例，取卧位，应用接触性热痛诱发电位刺激器，直径27mm（面积573mm^2），加热速度70℃／s。于54．5℃应用可调节脉冲，刺激部位为手背、前臂的掌侧面、第7颈椎棘突处（C7）。记录仪器：Keypoint．net仪器。记录点为Cz和Pz。同时进行躯体感觉诱发电位检测，记录其波形及潜伏期。并对60名健康对照者进行相应研究。结果肌萎缩侧索硬化患者接触性热痛诱发电位波形无异常，潜伏期分别为：手背刺激（561．2±28．6）ms，前臂掌侧刺激（540．1±39．2）ms，C7刺激（512．7±31．4）ms，与健康对照组[（558．7±30．2）、（536．6±23．5）、（501．8±26．0）ms]比较差异均无统计学意义（t=4．23、4．51、3．74，P〉0．05）。其躯体感觉诱发电位各波潜伏期、波间期均正常。结论肌萎缩侧索硬化患者接触性热痛诱发电位正常，提示其痛觉通路正常。

Objective To study the features of pain evoked potentials in patients with amyotrophic lateral sclerosis （ALS） and evaluate the pain pathway in these patients. Methods Sixty patients with ALS and 60 controls were set on supine position. The contact heat evoked potential stimulator with a diameter of 27 mm and an area of 573 mm^2 was used to elicit pain and contact heat evoked potentials （CHEP） in an accelerating speed of 70 ℃/s. Thermal stimuli were given at 54. 5 ℃ to three body sites： the dorsum of hand, proximal volar for arm and C7. CHEP was recorded at spots of Cz and Pz. The features of CHEP was observed. At the same time, somatosensory evoked potential （SEP） was assese＆ Results The figure and latency of CHEP in ALS patients were normal. The latency was： the dorsum of hand： （561.2 ±28.6） ms; proximal volar forarm： （540. 1 ±39. 2） ms; C7 ： （512.7 _±31.4） ms. There wereno significant differences of latency and SEP between the ALS patients and the controls （ （ 558.7± 30. 2 ）, （ 536. 6 ± 23.5 ）, （501.8±26.0）ms, t =4.23,4.51,3.74, P 〉0.05） . Conclusion Patients with ALS have a normal CHEP, suggesting that the pain pathway in patient with ALS is intact.