脑卒中病人磁性刺激运动诱发电位改变的初步探讨(附27例正常对照)

The prelimnarystudy of motor evoked potentials by magnetic stimulation in opoplexic patients——with 27 cases of normal control group

本文应用磁性刺激的新技术对34例脑卒中病人作运动诱发电位(MEP)检查,并与CT 资料及正常人作对照分析。结果发现不同的临床肌力皮层 MEP 表现各有差异。临床肌力4～5°的21例中,CT 无明显异常改变者9例;皮层 MEP 潜伏期延迟,但波幅改变与对照组无差异。肌力0～3°的13例中,CT 无明显异常改变者4例,皮层 MEP 之潜伏期和波幅有明显变化。本文资料说明 MEP 对检测运动传导系统的功能状态更正确而可靠。

This report concerns a non-invasive method inobtaining motor evoked potentials(MEPS)withmagnetic stimulation over the motor cortexand the Erb's point in 34 cases sufferingfrom cerebral vascular accident,eight of themwere hemorrhagic apoplexy and twenty-sixdue to occlusive cerebral disease.Havingcompared the materials of bilateral MEPS fromour patients,the normal control group MEPSand the CT scaning in all cases,we founddifferent muscle strength of patients withvariation of MEPS.There were 21 cases withalmost normal strength in clinic,12 of themshowed abnormal CT(57%),but the MEPSwaveform on abnormal side was different(P<0.01).There were 13 cases with abnormaldue to occlusive cerebral disease.Havingcompared the materials of bilateral MEPS fromour patients,the normal control group MEPSand the CT scaning in all cases,we founddifferent muscle strength of patients withvariarion of MEPS.There were 21 cases withalmost normal strength in clinic,12 of themshowed abnormal CT(57%),but the MEPSwaveform on abnormal side was different(P<0.01).There were 13 cases with abnormalmuscles strength,9 of them were abnormalin CT scaning,the MEPS waveforms wereobviously changed in all cases.This studyshows that motor evoked potentials is moreaccurate,retiable and sensitive in predictinghuman motor funtiou and generally there is no false positive or negative results.