磁运动诱发电位对小儿格林-巴利综合征的评估

Evaluation of magnetic motor evoked potentials in children with Guillain-Barre Syndreome

目的探讨磁运动诱发电位(MMEP)动态检测儿童格林-巴利综合征的重要性。方法对15例急性格林-巴利综合征(GBS)患儿应用磁刺激分段测定(C6/7、L4/5、肘和窝)周围运动传导通路功能,分别在上肢拇短展肌和下肢拇展肌肌腹处记录。结果MMEP阳性率93%,周围传导时间(PCT)异常率35%左右。重症GBSMMEP电位消失或呈异常低波幅多相波形伴潜伏期、时程显著延长(P<0.001)。结论动态检测MMEP可提高GBS的诊断阳性率,PCT可能有助于提示近端神经,尤其是神经根脱髓鞘病变。

Objective To explore the signification of magn etic motor evoked potentials(MMEPs )studied on 15children with acute Guillain-Barre Syndreome (GBS).Methods MMEPs along peripheral motor conduction pathways(C 6/7 ,L 4/5 ,elbow and poplitea fossa)were tested by using the magnetic stimula tion.The peripheral MMEPs at the abductor pollicis brevis(APB)and the abductor hallucis(AH)were recorded,respectively,and attain ed data were in comparison with those of age-matched normal subjects.Results The abnormal rate of MMEPs and peripheral conduction tim e(PCT)was 93%and about 35%,respectively.In 6cases severe with GBS motor evoked potentials followedmagnetic stimulation show ed disappearance or abnomal lower an d polyphasic shapes,significally i ncreased latencies and prolonged durations compared to normal subjec ts(P<0.001).Conclusion Sequential MMEPs investigations can boost the positive rate of diagnosis on GBS.Abnormal PCT may cue in the proximallesion of the peripheral motor nerve,particularly the demyelinatin g neuropathy of root.