三叉神经-颈反射对运动神经元病球部损害的诊断价值

Trigemino-cervical reflex: a new electrophysiological method in the diagnosis of motor neuron disease.

目的 建立三又神经-颈反射(TCR)的肌电检测方法,探讨其对运动神经元病(MND)球部损害的诊断价值。方法受检测者取仰卧位,头部轻度抬高。刺激一侧眶下神经,于双侧胸锁乳突肌记录。结果 刺激对照者一侧的眶下神经,可于双侧胸锁乳突肌引出正/负波。MND组:7例正常(23.3％),8例未引出(26.7％),11例潜伏期延长(36.7％),4例双侧反射超常不对称(13.3％)。结论TCR能够可靠测定,作为颈-球区病变的一种辅助检查手段,有助于运动神经元病的早期诊断。

Objective To study the physiological behavior and the value in the diagnosis of motor neuron disease (MND) of the trigeminocervical reflex. Methods The subjects held the heads slightly raised when lying supine to make the sternocleido-mastoid muscles tonically active. Electrical stimuli were applied to the infraorbital nerves and it was recorded from the sternocleido-mastoid muscles. Results In all control subjects, stimulation of the infraorbital nerve on one side produced bilateral positive and negative waves. In the group of MND, 7 patients showed nromal (23.3 % ) , 8 patients showed absent (26.7 % ) , 11 patients were delayed in latency (36.7% ), 4 patient was above normal asymmetry in the response on two sides (13.3% ) . Conclusions The trigemino-cervical reflex can be reliably measured. It may help in dislocating cervical-bulbar lesion and diagnosing motor neuron disease.