运动诱发电位在腰骶神经根病诊断中的意义  

Motor evoked potentials in diagnosis of lumbosacral radiculopathy

作　　者：吴建新[1] 傅鸿翔[2] 

机构地区：[1]解放军117医院神经科 [2]海军杭州疗养院康复中心,浙江杭州310002

出　　处：《第一军医大学学报》2000年第3期257-259,共3页Journal of First Military Medical University

摘　　要：目的 探讨分段脊神经根刺激运动诱发电位（MEP）在腰骶神经根病诊断中的意义。方法 选择L2、L5及S1神经病及正常对照各30例，采用L2及S1/L5椎体水平高压短脉冲电刺激，分别在比目鱼肌及半腱肌记录MEP。结果 ①正常脊髓运动传导时间（MNRCT）在 L5为（2.3±0.6）ms、S1为（2.9±0.5）ms，两侧差分别为（0±0.4）ms、（0±0.3）ms。②L5及S1神经根病患侧MNRCT较健侧及对照组显著延长。③S1及L5神经病患者S1神经孔或L5刺激时，M波潜伏期患侧较健侧显著缩短。④据MNRCT及其两侧差，比目鱼肌MEP对S1神经根病诊断的阳性率是83.3%和86.7%，半腱肌MEP对L5神经病的分别为56.7%和66.7%。结论 ①分段脊神经根刺激MEP有助于诊断腰骶神经根病。②MNRCT及其两侧差是MEP诊断的最佳指标。③S1或L5刺激时M波潜伏期患侧缩短可能跟神经病累及根远端致兴奋点远移有关，不能以此作为诊断依据。Objective Motor nerve root conduction time (MNRCT) was measured by motor evoked potentials (MEP) and its diagnosis use in lumbosacral radiculopathy was discussed. Method: 30 cases of S1 radiculopathy, 30 cases of L5 radiculopathy and 30 cases of normal subjects were selected. MEP elicited by nerve root electrical stimulation at difference site was performed, which were recording from soleus (S1) and semitendinosus muscle (L5). MNRCT were measured. Results The normal value of MNRCT was 2.9±0.5 ms in S1 root and was 2.3±0.6ms in L5 root. Its side-to side difference motor nerve root conduction time (DMNRCT) WAS 0±0.3 ms in S1 root and 0±0.4 in L5 root. The M wave latency at L5/S1 level stimulation was shortening significantly compared to healthy side. The positive rate were 83.3% according to MNRCT and 86.7to DMNRCT in S1 radiculopathy by soleus MEP and 56.7% according to MNRCT and 66.7%to DMNRCT in L5 radiculopathy by semitendinosus MEP in L5 radiculopathy. Conclusion The results indicated that MEP elicited by nerve root stimulation was useful in diagnosis of lumbosacral radiculopathy. MNRCT and its side-to-side difference was sensitive indicator in radiculopathy. The lesion may spread to distant of nerve roots. The excited site at L5/S1 stimulation may be more distantly in radiculopathy than in normal condition.

关 键 词：运动诱发电位 高压短脉冲电刺激 腰骶神经根病 

分 类 号：R745.4[医药卫生—神经病学与精神病学]