三叉神经痛微血管减压术后神经传导功能的恢复  

Recovery of trigeminal nerve conduction following microvascular decompression

作　　者：张晓华[1] 葛建伟[1] 毛青[1] 邱永明[1] 熊文浩[1] 李善泉[1] 罗其中[1] 徐忠贤[1] 

机构地区：[1]上海交通大学医学院附属仁济医院神经外科,上海200127

出　　处：《中华神经外科疾病研究杂志》2011年第2期105-108,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：上海市教育委员会科研创新项目资助项目(11YZ50)

摘　　要：目的评价三叉神经痛(TN)微血管减压术(MVD)前后三叉神经的功能恢复。方法本文研究了38例经磁共振三维层析血管成像术(MRTA)证实有神经血管接触的TN患者,在MVD过程中,通过术前、中、后记录早期头皮诱发电位监测三叉神经传导功能;同时从三叉神经出脑干区(REZ)直接记录诱发电位作为对照研究。结果所有病例的术前头皮诱发电位均显示三叉神经根部的传导功能损害。头皮诱发电位和根部直接记录电位证实MVD后32例患者三叉神经传导功能迅速恢复,所有患者术后疼痛均缓解。结论 MVD后TN的改善常与神经生理学数值恢复正常有关,提示神经传导功能的恢复。MVD后电生理数值的迅速恢复和疼痛缓解均证明这两种现象与髓鞘再生无关。Objective To evaluate recovery of trigeminal nerve conduction following microvascular decompression （MVD）.Methods A total of 38 patients with trigeminal neuralgia （TN） confirmed by magnetic resonance tomographic angiography （MRTA） were studied. Trigeminal nerve conduction was monitored and compared pre-MVD, intra-MVD and post-MVD by recording brainstem trigeminal evoked potentials （BTEP）. Results Pre-MVD BTEP of all cases indicated impaired conduction of the trigeminal root. Both BTEP and evoked potentials recorded from the REZ validated that trigeminal nerve conduction of all 32 cases recovered immediately postoperatively. All 38 patients got pain relief postoperatively.Conclusion Improvement in TN following MVD is often associated with restoration of neurophysiologic parameters, suggesting recovery of nerve conduction. Restoration of neurophysiologic parameters and pain relief both indicate that they are not associated with remyelination.

关 键 词：脑干三叉神经诱发电位 三叉神经痛 微血管减压术 神经传导功能 

分 类 号：R651.3[医药卫生—外科学]