体感诱发电位在神经性瘫痪中的定位价值

The localization value of somatosen soryevoked potentials for nerve par alysis

目的检测及分析小儿神经性瘫痪体感诱发电位(SEP),探讨SEP在小儿神经性瘫痪定位诊断中的价值。方法以180例0～14岁小儿刺激正中神经和胫后神经体感诱发电位正常值为标准,对临床有肢体瘫痪的335例年龄49d～13岁小儿的体感诱发电位进行分析比较。结果266例临床有痉挛性肢体瘫痪小儿,SEP异常率共为86.5%(230/266)。表现为脊髓和/或皮层SEP峰潜伏期记录延长或消失,而周围神经电位正常;脊髓疾病及脑性瘫痪SEP异常率较其他中枢神经疾病高,分别为92.6%(25/27)和86.3%(139/161);颅内病变中天幕上SEP异常较天幕下常见;69例临床周围性肢瘫SEP异常率20.3%(14/69);3岁以下年龄组与3岁以上年龄组之间异常率差异意义无显著性。结论体感诱发电位对小儿肢体瘫痪定位,特别是对临床工作中较难判断的小婴儿瘫痪定位诊断具有实用价值。

Aim To explore the value of somatosensory evoked potentials(SEP)on nerve paralysis.Methods Compared with the normal data of SEP evoked by median and posterior tibia l nerve in 180healthy children aged 0-14years old,the abnormal data of SEP were recorded in 335patients with extremity paralysis aged from 49day to 13years old.Results Among 266subjects with spastic paralysis,ab normal SEP accounted for 230cases(86.5%),whose manifestations were the dela y or effacement of main peak la-tencies of spinal and /or scalp,but s till within normal range of their pe-ripheral potentials.The SEP data of spinal disease and cerebral palsy we re92.6%and 86.3%respectively,both o f which were higher than those of other CNS diseases.In the cases of cranial lesion,the abnormal SEP in supratentorial lesions were more co mmon than that in postfovea .In the 69children with flaccid paralysis,20.3%(14/69patients)presented ab-normal peripheral potentials of SEP.The abnormal rates of SEP had not sig-nificant differences between upward and downward of 3years old.Conclu-sion SEP is very important to diagnosis pedo-palsy,especially some diffi-cult cases in clinic.