多发性硬化周围神经损害的临床和肌电图研究  

Peripheral neuropathy in multiple sclerosis: a clinical and electromyographic study

作　　者：郭丽华[1] 吴伟[2] 迟兆富[2] 刘学伍[2] 

机构地区：[1]山东大学齐鲁医院肌电图室,济南250012 [2]山东大学齐鲁医院神经内科,济南250012

出　　处：《临床神经病学杂志》2005年第1期22-24,共3页Journal of Clinical Neurology

摘　　要：目的　研究多发性硬化(MS)周围神经损害的临床及肌电图(EMG)特点。方法　回顾性分析 29例MS患者的临床及EMG检查资料。结果　本组18例(62.1%)有周围神经损害的临床表现和/或EMG 异常,其中肢体麻木16例(88.9%)、肢体乏力11例(61.1%)、神经根性疼痛5例(27.8%)、自主神经损害症 状3例(16.7%)、饮水呛咳和吞咽困难2例(11.1%);腱反射减低11例(61.1%)、末梢或根型感觉障碍9例 (50%)、肌力减低7例(38.9%)、肌萎缩4例(22.2%)、咽反射减低1例(5.6%)。其发病年龄、病程、神经功 能缺损程度及预后与11例不伴周围神经损害的MS患者基本相似。EMG检查发现自发电位4例(13.8%), 运动单位电位波幅增高、时限延长8例(27.6%)、运动神经传导速度减慢15例(51.7%)、感觉神经传导速度 减慢13例(44.8%)、波幅减低9例(31.1%)、远端潜伏期延长5例(17.2%)。经皮质类固醇等治疗周围神 经损害症状除1例双下肢麻木外,其余均随病情好转而恢复。结论　部分MS患者伴周围神经损害表现,可 随病情好转而恢复;EMG可帮助判断周围神经损害的部位和程度。Objective To investigate the clinical and electromyographic features of peripheral nerve involvement in MS. Methods The clinical and electromyographic (EMG) data of 29 MS patients were evaluated retrospectively.Results 18 (62.1%) patients showed clinical and/or electromyographic abnormalities of peripheral nerves. The clinical symptoms included extremity numbness in 16 cases (88.9%), limb inertia in 11 cases (61.1%), radicular pain in 5 cases (27.8%), autonomic nerve disorder and dysphagia in few patients. Signs included decrease of tendon reflex in 11 cases (61.1%), periphery or root form hypoesthesia in 9 cases (50%), muscle weakness in 7 cases (38.9%), myatrophy in 4 cases (22.2%), and reduced pharyngeal reflex in 1 case (5.6%). There was no difference in age of onset, course of disease, neurologic impairment and prognosis between the patients accompanied with peripheral neuropathy and the patients without peripheral neuropathy. The electromyographic abnormalities included spontaneous potential in 4 cases (13.8%), increased motor unit potential in 8 cases (27.6%), slow MCV in 15 cases (51.7%), slow SCV in 13 cases (44.8%), low amplitude in 9 cases (31.1%), and prolonged distal latency in 5 cases (17.2%). The neuropathies improved by treatment with corticosteroid in the all patients except one.Conclusions Some MS patients may accompany with peripheral nerve abnormalities, which may improve with the recovery of MS. EMG is useful to evaluale the site and degree of peripheral nerve damage.

关 键 词：多发性硬化 周围神经损害 肌电图 

分 类 号：R744.51[医药卫生—神经病学与精神病学]