体感诱发电位在小儿脊髓疾病中定位诊断的研究

The study of localization value of somatosensory evoked potentials for spinal cord lesions in children

目的 探讨体感诱发电位 (SEP)在小儿脊髓疾病中的定位诊断价值。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 ,对临床诊断脊髓疾病的 71例年龄 2个月～ 13岁小儿的体感诱发电位进行分析比较。结果 71例临床诊断脊髓疾病的小儿SEP总异常率 95 8% (6 8/ 71) ,3例脊柱畸形SEP正常。其中周围神经SEP异常率为2 9 4 % (2 0 / 6 8) ,脊髓SEP异常率为 88 2 % (6 0 / 6 8) ,皮层SEP异常率为 75 % (5 1/ 6 8)。表现为峰潜伏期记录延长或消失 ;6 8例异常SEP中 ,除 1例颈椎外伤病人正中神经SEP异常外 ,其余 6 7例患儿的正中神经SEP均为正常。结论 正确利用正中神经。

Objective To explore the significance of the localization of somatosensory evoked potentials for spinal cord lesions in children.Methods Comparing the normal data of somatosensory evoked potentials(SEP)along medium and posterior tibial nerve in 180 healthy children aged 0～14 years,71 patients aged from 2 month to 13 years with spinal cord lesions were recorded by SEP for diagnostic purpose.Results Among the 71 subjects with spinal cord lesions,abnormal SEP were present in 68/71 cases(95 8%).Three cases with spinal deformity demonstrated normal SEP.Abnormal SEP of peripheral potentials were present in 29 4%(20/68) and spinal cord lesions were 88.2%(60/68).There were 75%(51/68)abnormal present in scalp recording.Consisting of delayed latencies of main peak or completely absence of spinal and/or scalp recording.In the cases of cranial lesion,the abnormalities SEP in supratentorial lesions were more common than postfovea.In the 68 children with abnormal SEP,except one with cervical vertebral trauma who had abnormal medium SEP,67 patients meduim SEP were normal.Conclusion The results of the study indicate that SEP is very important to determinate the possible location pathologically for spinal cord lesions.