[刺激胫神经后的脊髓和皮质下体感诱发电位]。

B Riffel, M Stöhr
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引用次数: 6

摘要

记录30例正常人踝关节棘突L5、L1、C2和Cz′上单侧刺激胫后神经的诱发电位。L5以上记录的“尾电位”由两个小的负峰组成,平均潜伏期分别为18和22.5 ms,而L1以上记录的“绳电位”的峰值潜伏期为21.2 ms,平均幅度比两个“尾电位”中的第一个大3倍(图1)。来自棘突C2的导联显示一个尖锐的负峰,平均峰潜伏期为28.8 ms (N 30)。中额叶(Fz-)参考的头皮记录不一致地显示在初级皮层反应(P40)之前有1-2个小波(P31, N33)。耳部或非头侧的记录一致显示一个大的正偏斜(P30),与同时记录的颈椎反应(N30)相对应,随后是一个明显的负电位(N33)(图2a和b)。不同脊髓和皮层下诱发电位的平均潜伏期和振幅(表1和2),以及诊断上更重要的间隔时间、振幅关系,计算潜伏期和振幅的侧差(表3和表4)。这些参数的诊断意义将在选定的脊髓病理病例中显示。
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[Spinal and subcortical somatosensory evoked potentials after stimulation of the tibial nerve].

Evoked potentials in response to unilateral stimulation of the posterior tibial nerve at the ankle were recorded above the spinous processes L5, L1, C2, and at Cz' in 30 normal subjects. The "cauda-potential" recorded above L5 consists of two small negative peaks with a mean latency of 18 and 22.5 ms respectively, whereas the "cord-potential" recorded above L1 exhibited a peak latency of 21.2 ms and on average a three-times larger amplitude than the first of the two "cauda-potentials" (Fig. 1). Leads from the spinous process C2 revealed a sharp negative peak with a mean peak latency of 28.8 ms (N 30). Scalp recordings with a midfrontal (Fz-) reference inconsistently showed 1-2 small waves (P31, N33) prior to the primary cortical response (P40). Recordings with an ear- or non-cephalic reference consistently showed a large positive deflection (P30) which corresponded in latency with the simultaneously recorded cervical response (N30) and was followed by a distinct negative potential (N33) (Fig. 2a and b). Average latencies and amplitudes of the different spinal and subcortical evoked potentials (Tables 1 and 2), as well as the diagnostically more important interpeak-intervals, amplitude relations, and side-differences of latencies and amplitudes (Tables 3 and 4) were calculated. The diagnostic significance of these parameters will be shown in selected cases with spinal cord pathology.

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