儿童Bell＇s麻痹患者的脑干听觉诱发电位研究

Study of brainstem auditory evoked potentials in children with Bell＇s palsy

目的 应用脑干听觉诱发电位对儿童Bell＇s麻痹患者的听神经及脑干功能进行评估.方法 回顾性分析2017年1月至2018年1月于中国医科大学附属盛京医院儿科住院的69例Bell＇s麻痹患儿资料.男33例,女36例,年龄1～12岁,病程1～6 d.常规脑电图检测及头部CT或MRI检测,排除肿瘤、颅内感染等.常规法检测脑干听觉诱发电位（brainstem auditory evoked potentials,BAEP）.病例组依年龄分为1～3岁组（38例）和4～12岁组（31例）.健康对照组选择中国医科大学附属盛京医院发育儿科门诊正常体检儿童,1～3岁30例,4～12岁30例.结果 健康对照组双耳听力均正常.1～3岁组和4～12岁组健康儿童BAEP检测Ⅰ、Ⅲ、Ⅴ波各波潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ间期左右耳对比差异均无统计学意义（P〉0.05）.病例组BAEP异常率为39.1％（27/69）.临床治疗2周后复查,19例恢复正常（70.4％）.另外8例2个月后再次复查恢复正常.脑电图异常率5.8％（4/69）,头部CT、MRI检测异常率14.5％（10/69）.均为非特异性改变.两组患儿患侧Ⅰ-Ⅲ间期均较健侧显著缩短（P〈0.05）,Ⅲ-Ⅴ间期均较健侧显著延长（P〈0.05）.两组患儿患侧耳临床治疗前后对比,Ⅲ波潜伏期、Ⅰ-Ⅲ间期及Ⅲ-Ⅴ间期均有显著差异（P〈0.05）.结论 儿童Bell＇s麻痹患者可能造成听神经中枢传导功能异常,BAEP可早期发现.

Objective To evaluate the function of auditory nerve and brainstem in children with Bell＇s palsy by using brainstem auditory evoked potential （ BAEP） . Methods A retrospective study was car-ried in total of 69 patients with Bell＇s palsy admitted in the pediatric department of Shengjing Hospital of China Medical University from January 2017 to January 2018. There were 33 males and 36 females,aged 1 to 12 years old. Sixty healthy children served as control group. BAEP were determined in 69 patients and 60 healthy subjects. EEG and CT or MRI of brain were performed to exclud tumor,intracranial infection and so on. The patients in the case group were divided into 2 groups：1-3 years old group （38 cases） and 4-12 years old group （31 cases）. Sixty healthy children were also divided into 2 groups：1-3 years old group （30 cases） and 4-12 years old group （30 cases）. Results The hearing threshold was normal in the children of the control group. There was no significant difference not only in potential latency but also internal potential latency of BAEP between right and left ear. The abnormal rate of BAEP was 39. 1％ （ 27/69 ） in case groups,19 cases of them recovered（70. 4％,19/27） after 2 weeks of clinical treatment. Another 8 patients re-covered after 2 months. The abnormality rate of EEG was 5. 8％ （4/69）,and the abnormality rate of CT or MRI in head was 14. 5％ （10/69）. Both were nonspecific changes. In the two groups,Ⅰ-Ⅲinternal potential latency was significantly shortened （ P 〈0. 05 ） , and Ⅲ-Ⅴinternal potential latency was significantly pro-longed （P〈0. 05）respectively,between the normal side and abnormal side. There were significant differences in the Ⅲ potential latency（P〈0. 05）,Ⅰ-Ⅲinternal potential latency （P〈0. 01）,and Ⅲ-Ⅴ internal poten-tial latency （ P 〈0. 01 ） respectively, between pretherapy and post-treatment. Conclusion Bell＇s palsy of children could cause abnormal of auditory nerve conduction,and BAEP could find the electro physiologic ab-normality in nervous system,and guide clinical intervention.