摘要
目的:回顾性分析24例腓骨肌萎缩症的临床与神经电生理特点。方法:收集1996-03/2006-01广州市第一人民医院收治的24例腓骨肌萎缩症患者,对其进行肌电图和肢体远端神经传导速度检测,观察上下肢感觉及运动传导速度、肌电图的改变,分析电生理特点与临床之间的关系。结果:①全部患者均隐袭起病,进展缓慢,临床上以下肢无力或麻木为首发症状,随病情发展,受累部位增加。②常规神经传导检查均有感觉及运动传导速度减慢,其中16例Ⅰ型患者(脱髓鞘型,神经传导速度低于正常值50%)减慢更明显,其正中神经运动神经传导速度平均34.8m/s,感觉神经传导速度平均27.9m/s;尺神经运动神经传导速度平均37.2m/s,感觉神经传导速度平均24.6m/s;腓总神经运动神经传导速度平均16.5m/s;胫神经运动神经传导速度平均17.4m/s;腓肠神经感觉神经传导速度平均3.1m/s。传导速度减慢与肌力受累程度不成比例,即肌无力程度相对较轻,感觉及运动传导速度减慢较重,其中有8例双下肢远端神经传导速度测不出,但患者尚能行走。③针电极肌电图检查可见明显的慢性神经源性损害特征,部分患者有巨大单位。结论:临床表现是诊断腓骨肌萎缩症的基础,感觉及运动传导速度测定是确诊腓骨肌萎缩症简单、易行、重复性好的最有价值的手段之一,且可以发现早期和临床无异常的患者。
AIM： To retrospectively analyze the clinical and electrophysiological featuros of the peroneal muscular atrophy （PMA） in 24 cases. METHODS： Twenty-four patients with PMA treated in the Guangzhou First People＇s Hospital between March 1996 and January 2006 were selooted and given electromyography and body distal nerve conductive velocity detection; the feelings of upper and lower limbs and changes of motor conductive velocity and electromyography were observed to explore the relationship between electrophysiological features and clinic. RESULTS： ①All the patients were characterized by insidious onset and gradual progression with lower limb asthenia or numbness as the first symptoms in clinic, meanwhile, with the development of condition, the involved parts increased. ②The patients had feelings in routine nerve conductive detection, and the motor conductive velocity slowed, in which the slowness was more obvious in 16 type Ⅰ patients （demyelination, the nerve conductive velocity was 50% lower than normal value）, whose mean median nerve conductive velocity was 34.8 m/s, sensory nerve mean conductive velocity 27.9 m/s; ulnar nerve mean conductive velocity 37.2 m/s, sensory nerve mean conductive velocity 24.6 m/s; common peroneal nerve mean conductive velocity 16.5 m/s; tibial nerve mean conductive velocity 17.4 m/s; sensory nerve of sural nerve mean conductive velocity 3.1 m/s. The slowness of conductive velocity and myodynamia were out of proportion, i.e. the muscular asthenia degree was comparatively lighter but the slowness of sensory and motor conductive velocity was more serious, in which the distal nerve conductive velocity of lower limb in 8 cases could not be detected, but the patients could still walk. ③Obvious features of chronic neurogenic injury were found by needle electrode electromyography, and some patients had giant units. CONCLUSION： Clinical manifestation is the foundation to make a diagnosis for PMA; sensory and motor conductive velocity detection is a simple, easy, good-repetitive and most valuable method to determine the PMA, which can.also find patients without abnormity in early phase and clinic.
出处
《中国临床康复》
CSCD
北大核心
2006年第22期93-95,共3页
Chinese Journal of Clinical Rehabilitation
