神经电图-肌电图检测对多灶性运动神经病的评估作用

Assessment of multifocal motor neuropathy with electroneurography and electromyography

目的:探讨神经电图(ENG)和肌电图(EMG)检查对多灶性运动神经病(multifocalmotorneuropathy,MMN)的诊断价值及康复干预的评估作用。方法:对16例诊断为MMN的患者进行电生理检查,受试者为MMN组16例和正常组16例,分别进行运动神经传导速度(MCV)和感觉神经传导速度(SCV)检查,记录刺激引出的复合肌肉动作电位(compoundmus-cleactionpotentials,CMAP)的波幅、波宽、面积、位相、时限进行对比分析,判定是否有运动神经传导阻滞(conductionblock,CB)或暂时性离散(temporaldispersion,TD)。并有选择性地进行常规肌电图检查。结果:16例患者中均见有一根以上运动神经或至少一根运动神经的一个以上部位出现CB或TD。其中13例双上肢正中神经,尺神经出现CB,3例首发为正中神经尺神经的远端出现CB,随病情进展出现下肢腓深神经CB。仅有两例感觉神经传导速度稍有减慢,波幅略有降低。16例患者神经受累区域以下所支配肌肉肌电图检查见有运动神经源性受损改变。结论:MMN病是一种以远端神经受累为主的不对称性周围神经病,神经电生理检查对诊断和鉴别诊断MMN起重要作用,CB是MMN特征性表现。

AIM:To explore the value of electroneurogram (ENG) and electromyogram (EMG) i n diagnosis of multifocal motor neuropathy (MMN) and in evaluation of rehabilita tion intervention. METHODS:Sixteen patients diagnosed as MMN were enrolled as the MMN group, and 16 healthy volunteers were used as controls. Motor nerve conduction velocity (M CV) and sensory nerve conduction velocity (SCV) were measured in the two groups. Amplitude, width, area, phases and duration of compound muscle action potential s were recorded and compared to determine whether conduction block (CB) or tempo ral dispersion existed (TD). EMG in routine was conducted in the subjects select ively. RESULTS:CB or TD was present in more than one motor nerve or more than one sit e of a motor nerve at least in the 16 patients with MMN. CB was showed in median nerve and ulnar nerve of both upper extremities of 13 MMN cases, and the other 3 cases showed CB in the distal part of median and ulnar nerves firstly, and the n CB was found in deep peroneal nerves of lower limb with the development of the conditions. SCVs slowed down slightly and the amplitude decreased only in 2 cas es of MMN. EMG showed motor neurogenic damages in the muscles suffered from the affected nerves.