经颅皮层电刺激对脊髓损伤的诊断价值  

Value of transcranial electrical stimulation motor evoked potential(TES-MEP)in the diagnosis of position of spinal cord injury

作　　者：徐国卫[1] 刘欣[1] 王晓楠[2] 张斌[3] 张红霞[3] 贾新州[1] 宋新光[3] 

机构地区：[1]郑州市中心医院神经内科二病区,河南郑州450007 [2]郑州市中心医院感染控制科,河南郑州450007 [3]郑州市中心医院肌电图室,河南郑州450007

出　　处：《中国现代医学杂志》2012年第10期59-61,共3页China Journal of Modern Medicine

基　　金：郑州市科技攻关课题项目(No:0910SGYS33376-3)

摘　　要：目的探讨经颅皮层电刺激运动诱发电位对脊髓损伤的定位诊断价值。方法对2008年5月～2011年4月在我院临床拟诊脊髓损伤的53例患者,经颅对皮层运动区行电刺激多导联描记肢体肌的MEP,测定MEP的潜伏期和波幅。结果 53例患者中有35例脊髓MEP异常,其中颈段MEP异常20例,胸、腰段MEP异常15例,其余18例患者脊髓MEP正常。颈段脊髓损伤患者拇短展肌和胫前肌MEP潜伏期延长,波幅降低,与MEP正常组比较,差异有显著性(P<0.05)。胸、腰段脊髓损伤患者下肢胫前肌MEP潜伏期延长,波幅降低,与MEP正常组比较,差异有显著性(P<0.05)。对35例中31例(88.57%)进行了影像学检查,其中28例(90.03%)患者在MEP提示节段发现脊髓病变。结论经颅皮层电刺激MEP是一种操作简便、安全可靠的脊髓损伤定位诊断方法。【Objective】 To explore the value of transcranial electrical stimulation motor evoked potential（TES-MEP）in the diagnosis of position of spinal cord injury（SCI）.【Methods】 53 patients clinically diagnosed as SCI received TES-MEP from May.2008 to Apr.2011.The latency and amplitude of MEP were observed and compared.【Results】 Of 53 patients,abnormal MEP showed in 35 cases and normal MEP in 18 cases.Compared with normal MEP group,the latency was prolonged and amplitude decreased in MEP of short abductor muscle of thumb and anterior tibial muscle in patients with cervical SCI（P 0.05）.Compared with normal MEP group,the latency was prolonged and amplitude decreased in MEP of anterior tibial muscle in patients with thoracic and lumbar SCI（P 0.05）.31 of 35 patients（88.57%） were respectively inspected by means of CT,MRI and spinogram.In 31 patients inspected,myeleterosis appeared at the sites pointed up by MEP in 28 patients（90.03%）.【Conclusions】 Transcranial electrical stimulation motor evoked potential is a simple,convenient and accurate method in the diagnosis of position of spinal cord injury.

关 键 词：MEP 脊髓 定位诊断 

分 类 号：R744[医药卫生—神经病学与精神病学]