运动诱发电位在脑血管病运动功能康复中的应用

Transcranial magnetic motor evoked potentials as a prognostic indicator for motor recovery in patients with acute ischemic stroke

目的 通过测定脑血管病患者发病后运动诱发电位 (MEP) ,验证MEP在预测梗死后运动功能恢复中的作用。方法 选取 2 9例大脑中动脉梗死的患者 ,在发病的第 1日行经颅磁刺激 (TMS)检查 ,记录其MEP ,同时进行临床评价 ,在发病的第 2 8日 ,所有检查再重复一次。结果 在发病第 1日能够引出MEP的患者 ,其预后较不能够引出的患者运动功能恢复好。结论 对脑梗死患者在急性期行MEP检查 ,是评价患者将来运动功能康复的一项客观、安全、有效的预测手段。

Objective To evaluate the role of motor evoked potentials(MEP) in predicting the functional recovery of patients with acute ischemic stroke.Methods Twenty nine patients with different degrees of hemiparesis were evaluated clinically and electrophysiologically in the first days and 28 th day after the event.Clinical assessment included Fugl Meyer assessment and Barthel index.TMS was performed at the same time,the motor evoked potential in the thumb abductor muscle was recorded.Correlation between clinical parameters and MEP were assessed.Results Of the total group of 29 patients,MEP was absent in 15 and present in 14[with 8 normal and 6 with delay central motor conduction time ( CMCT )] at the first day. The patients with MEP showed better motor and functional recovery than those without.The MEP provided information on patient recovery, regardless of the initial FMA and/or Barthes values.Conclusions MEP obtained by TMS in patients with hemiparesis after acute ischemic stroke is useful as an early prognostic indicator of motor and functional recovery.