BACKGROUND： The electrophysiological test was mainly achieved by the reaction of nerve fiber to electrical stimulus, usually expressed by the amplitude and latency. Blink reflex and electroneurography （ENOG） are wi...BACKGROUND： The electrophysiological test was mainly achieved by the reaction of nerve fiber to electrical stimulus, usually expressed by the amplitude and latency. Blink reflex and electroneurography （ENOG） are widely applied in facial paralysis, the amplitude would step down, and the latency would prolong when the facial nerve was injured. OBJECTIVE： To compare the value of blink reflex and ENOG in the diagnosis of facial paralysis （Bell＇s palsy）. DESIGN： A controlled trial. SETTINGS： Affiliated Hospital, Chengdu University of Traditional Chinese Medicine; West China Hospital of Sichuan University; Mianyang Hospital of Traditional Chinese Medicine; Sichuan People＇s Hospital. PARTICIPANTS： The patients who had finished the tests of blink reflex （n =207） and ENOG （n =205） were selected from the Affiliated Hospital, Chengdu University of Traditional Chinese Medicine; West China Hospital of Sichuan University; Mianyang Hospital of Traditional Chinese Medicine; Sichuan People＇s Hospital from September 2001 to July 2003. After treatment for 4 weeks, the patients finished tests of blink reflex （n =207） and ENOG （n =205） were randomly divided into primary treatment group （n =68, 69）, acupuncture group （n =71, 66） and comprehensive treatment group （n =68, 70）, respectively. Approval was obtained from the ethic committee of hospital. METHODS： Patients in the primary treatment group and acupuncture group were treated with western medicine, acupuncture and moxibustion alone respectively, and those in the comprehensive treatment group were treated with acupuncture and moxibustion based on western medicine. The whole period of treatment was 4 weeks. The tests of blink reflex and ENOG were carried out using Japanese light and electricity MEB-2200 electromyogram/induced potential instrument for once before and after treatment respectively. The normal value of the latency period of wave RI was within 13 ms, and the difference was 1 - 1.2 ms between the left and right sides. MAIN OUTCOME MEASURES： The latency of wave RI of blink reflect and the latency and wave amplitude of ENOG on the affected and healthy sides before and after treatment were observed. RESULTS： Totally 207 and 205 patients received tests of blink reflex and ENOG, but 17 and 16 cases respectively did not finish the second measurement, finally 190 and 189 cases were involved in the analysis of results. The latencies of wave R 1 on the affected side after treatment were significantly longer than those before treatment （t = - 6.253, P 〈 0.01）; The latencies of wave RI on the normal side were in the normal range before and after treatment; The latencies of wave RI before treatment on the affected side was significantly longer than that on the normal side （t =- 5.896, P 〈 0.01）, but there were no significant differences between the affected and normal sides after treatment （P 〉 0.05）. It was indicated that the latencies of wave RI on the affected side had restored normally, and the blink reflex was improved obviously after treatment. The latency of ENOG on the affected side before treatment was significantly prolonged as compared with that on the normal side （t =2.247, P 〈 0.01）; After treatment, the difference between the affected and normal side became smaller, but remarkable significance still existed （t =10.810, P 〈 0.01）. In spite of the obvious improvement of affected side before and after treatment, there were still significant differences （t =- 8.110, P 〈 0.05）. The wave amplitude on the affected side was decreased after treatment, which was not significantly different from that before treatment （P 〉0.05）. CONCLUSION： After treatment of facial paralysis, blink reflect was greatly improved, there was an obvious hysteresis in the latency of ENOG. Therefore, blink reflect was better than ENOG in the early diagnosis, while ENOG was suitable for evaluating the prognosis. The ENOG examination was better than blink reflex at middle and late period.展开更多
目的:探讨术前面神经电图预测腮腺肿瘤患者面神经受侵状态的可行性。方法:53例腮腺原发性肿瘤患者,其中良性肿瘤28例,恶性肿瘤25例。两组间肿瘤部位及大小相近,术前House-Brackmann(H-B)面神经功能评分均为Ⅰ级。所有患者行双侧面神经...目的:探讨术前面神经电图预测腮腺肿瘤患者面神经受侵状态的可行性。方法:53例腮腺原发性肿瘤患者,其中良性肿瘤28例,恶性肿瘤25例。两组间肿瘤部位及大小相近,术前House-Brackmann(H-B)面神经功能评分均为Ⅰ级。所有患者行双侧面神经电图检查,结合术中所见及病理检查结果,对比同一患者两侧耳前、耳后刺激时的波幅和潜伏时,进行Wilcoxon符号秩检验和受试者工作特征曲线分析。结果:腮腺良性肿瘤患者,诱发面神经最大动作电位的刺激电流平均为20.0 m A,10.7%患者患侧耳后刺激时面神经的Ⅰ或Ⅱ支无反应波引出,患侧耳后刺激面神经电图的波幅较健侧下降(P<0.05)。恶性肿瘤患者,诱发面神经最大动作电位的刺激电流平均为24.5m A,显著高于良性肿瘤患者(P=0.001)。36.0%患者患侧耳后刺激时多条面神经分支神经电图无反应波引出,其比例高于良性肿瘤患者(P=0.028)。患侧面神经耳后刺激时神经电图的波幅与健侧相比明显降低或无反应波(P<0.05),潜伏时较健侧延长(P<0.05)。面神经电图的ROC曲线下面积为0.884。结论:面神经受侵时,诱发面神经最大动作电位的刺激电流强度增高,耳后刺激时面神经电图的波幅较健侧降低,恶性肿瘤患者无反应波引出者的比例增高。无面瘫症状的腮腺肿瘤患者,术前面神经电图检查有助于预测面神经受侵状态。展开更多
基金the Clinical Research Topic Fund in 2000–2001 from the State Administration of Traditional Chinese Medicine, No.00-01LP50
文摘BACKGROUND： The electrophysiological test was mainly achieved by the reaction of nerve fiber to electrical stimulus, usually expressed by the amplitude and latency. Blink reflex and electroneurography （ENOG） are widely applied in facial paralysis, the amplitude would step down, and the latency would prolong when the facial nerve was injured. OBJECTIVE： To compare the value of blink reflex and ENOG in the diagnosis of facial paralysis （Bell＇s palsy）. DESIGN： A controlled trial. SETTINGS： Affiliated Hospital, Chengdu University of Traditional Chinese Medicine; West China Hospital of Sichuan University; Mianyang Hospital of Traditional Chinese Medicine; Sichuan People＇s Hospital. PARTICIPANTS： The patients who had finished the tests of blink reflex （n =207） and ENOG （n =205） were selected from the Affiliated Hospital, Chengdu University of Traditional Chinese Medicine; West China Hospital of Sichuan University; Mianyang Hospital of Traditional Chinese Medicine; Sichuan People＇s Hospital from September 2001 to July 2003. After treatment for 4 weeks, the patients finished tests of blink reflex （n =207） and ENOG （n =205） were randomly divided into primary treatment group （n =68, 69）, acupuncture group （n =71, 66） and comprehensive treatment group （n =68, 70）, respectively. Approval was obtained from the ethic committee of hospital. METHODS： Patients in the primary treatment group and acupuncture group were treated with western medicine, acupuncture and moxibustion alone respectively, and those in the comprehensive treatment group were treated with acupuncture and moxibustion based on western medicine. The whole period of treatment was 4 weeks. The tests of blink reflex and ENOG were carried out using Japanese light and electricity MEB-2200 electromyogram/induced potential instrument for once before and after treatment respectively. The normal value of the latency period of wave RI was within 13 ms, and the difference was 1 - 1.2 ms between the left and right sides. MAIN OUTCOME MEASURES： The latency of wave RI of blink reflect and the latency and wave amplitude of ENOG on the affected and healthy sides before and after treatment were observed. RESULTS： Totally 207 and 205 patients received tests of blink reflex and ENOG, but 17 and 16 cases respectively did not finish the second measurement, finally 190 and 189 cases were involved in the analysis of results. The latencies of wave R 1 on the affected side after treatment were significantly longer than those before treatment （t = - 6.253, P 〈 0.01）; The latencies of wave RI on the normal side were in the normal range before and after treatment; The latencies of wave RI before treatment on the affected side was significantly longer than that on the normal side （t =- 5.896, P 〈 0.01）, but there were no significant differences between the affected and normal sides after treatment （P 〉 0.05）. It was indicated that the latencies of wave RI on the affected side had restored normally, and the blink reflex was improved obviously after treatment. The latency of ENOG on the affected side before treatment was significantly prolonged as compared with that on the normal side （t =2.247, P 〈 0.01）; After treatment, the difference between the affected and normal side became smaller, but remarkable significance still existed （t =10.810, P 〈 0.01）. In spite of the obvious improvement of affected side before and after treatment, there were still significant differences （t =- 8.110, P 〈 0.05）. The wave amplitude on the affected side was decreased after treatment, which was not significantly different from that before treatment （P 〉0.05）. CONCLUSION： After treatment of facial paralysis, blink reflect was greatly improved, there was an obvious hysteresis in the latency of ENOG. Therefore, blink reflect was better than ENOG in the early diagnosis, while ENOG was suitable for evaluating the prognosis. The ENOG examination was better than blink reflex at middle and late period.
文摘目的:探讨术前面神经电图预测腮腺肿瘤患者面神经受侵状态的可行性。方法:53例腮腺原发性肿瘤患者,其中良性肿瘤28例,恶性肿瘤25例。两组间肿瘤部位及大小相近,术前House-Brackmann(H-B)面神经功能评分均为Ⅰ级。所有患者行双侧面神经电图检查,结合术中所见及病理检查结果,对比同一患者两侧耳前、耳后刺激时的波幅和潜伏时,进行Wilcoxon符号秩检验和受试者工作特征曲线分析。结果:腮腺良性肿瘤患者,诱发面神经最大动作电位的刺激电流平均为20.0 m A,10.7%患者患侧耳后刺激时面神经的Ⅰ或Ⅱ支无反应波引出,患侧耳后刺激面神经电图的波幅较健侧下降(P<0.05)。恶性肿瘤患者,诱发面神经最大动作电位的刺激电流平均为24.5m A,显著高于良性肿瘤患者(P=0.001)。36.0%患者患侧耳后刺激时多条面神经分支神经电图无反应波引出,其比例高于良性肿瘤患者(P=0.028)。患侧面神经耳后刺激时神经电图的波幅与健侧相比明显降低或无反应波(P<0.05),潜伏时较健侧延长(P<0.05)。面神经电图的ROC曲线下面积为0.884。结论:面神经受侵时,诱发面神经最大动作电位的刺激电流强度增高,耳后刺激时面神经电图的波幅较健侧降低,恶性肿瘤患者无反应波引出者的比例增高。无面瘫症状的腮腺肿瘤患者,术前面神经电图检查有助于预测面神经受侵状态。
