摘要
目的探讨位移技术在运动神经部分传导阻滞(CB)诊断和鉴别诊断中的价值。方法在30名健康对照、44例肌萎缩侧索硬化症、38例脱髓鞘疾病患者同时进行常规节段的运动神经传导速度测定和位移技术测定,对检测结果进行分析。结果在健康对照,采用常规节段和位移技术测定均未检测到CB;在肌萎缩侧索硬化症患者中,常规节段检测时在4例患者中发现2处CB、2处可能的CB,但采用位移技术进一步测定时,未检测到短节段的CB;在脱髓鞘疾病,采用常规节段检测未能达到CB标准的18根神经中,采用位移技术检测时在13根神经发现存在短节段的CB。结论位移技术可以提高CB诊断的准确率;并有助于鉴别相位抵消和传导阻滞,有利于肌萎缩侧索硬化症和脱髓鞘疾病的鉴别。
ObjectiveTo determine the value of Inching technique in detection of conduction block (CB) and to explore the natures of CB. Methods3 groups of subjects including 30 healthy controls, 44 patients with amyotrophic lateral sclerosis (ALS),38 patients with demyelinating neuropathy (14 patients with acute inflammatory demyelinating polyradiculoneuropathy, 12 with chronic inflammatory demyelinating polyradiculoneuropathy and 12 with multifocal motor neuropathy) were recruited in 4 years. Standard segmental motor nerve conduction study and inching technique were performed in median nerves and ulnar nerves simultaneously. The features of segmental motor nerve conduction study in different groups were compared. Results (1) According to the criteria recommended by American Association of Electrodi-agnostic Medicine, 4 standard segments of 4 patients with ALS met the criteria of CB or probable CB but not confirmed by Inching technique. (2) For the standard segments with a reduction in amplitude from 20% to 40%, when measured by Inching technique, 21 short segments with CBs and 18 probable CBs were detected in 18 nerves of patients with demyelinating neuropathy, while no CB in 19 nerves of patients with ALS. (3) In segments with a reduction in amplitude of 20% or less, no CB was detected in all the subjects studied. (4) Abnormal temporal dispersions were detected across standard segment in 5 nerves, when studied with Inching technique, CBs across a short segment were detected in the same nerves. Conclusions(Inching technique) should be more sensitive in detecting CB, and could eliminate the influence of phase cancellation in some degree and extract CB from abnormal temporal dispersion. But for segments with a reduction in amplitude of 20% or less, Inching technique should not be recommended.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第5期283-285,共3页
Chinese Journal of Neurology
