摘要
目的：探讨三叉神经诱发电位（TSEP）与瞬目反射（BR）检查在特发性三叉神经痛（ITN）中的临床应用比较.方法：采用丹麦产Dantic keypoint多道肌电图-诱发电位仪,对168例ITN患者进行患侧与健侧的TSEP与BR检查,并对其结果进行对比分析. 结果： TSEP提示患侧三叉神经的短潜伏期延长、波幅降低,与健侧比较差异有显著意义（P〈0.01） TSEP的变化与ITN的病程长短及临床表现严重程度有关.而BR提示三叉神经潜伏期与健侧比较差异无显著意义（P〉0.05）,说明患者ITN三叉神经第一支受损较少.TSEP的异常率明显高于BR,是因为TSEP刺激为上颌神经与BR刺激为眼神经的刺激点不同,所以在三叉神经周围结构病变中不具有可比性.结论：TSEP与BR检查是评价三叉神经周围结构和脑干中枢传导通路生理功能的重要方法,有助于对ITN的定性及定量诊断.但因TSEP和BR的波型不稳定、干扰成分大、刺激与记录方法有待标准化、神经解剖与神经电生理基础还有待于进一步明确.
Objective： To compare and explore clinical application of trigeminal somatosensory evoked potential （TSEP）and blink reflex（BR） in patients with idiopathic trigeminal neuralgia （ITN）. Methods： With Dantic keypoint multi-lead evoked potentials monitor the examinations of TSEP and BR of both the affected lateralities and contralaleralities （healthy sides）in 168 patients with ITN were carriedout and the test results were analysed. Results： The latency of the affected lateralities were prolonged and its amplitudes were declined with significant difference in TSEP between the healthy lateralities and the affected lateralities （P〈0.01）. Changes of TSEP was significantly correlated with course and severity of in patients with ITN, BR showed theat there was no difference in the latencies between the two lateralities （P〉0.05）. First division of trigeminal nerves suffered from less damage. TSEP showed different stimulating points in the maxillary nerves,form BR in the ophthalmic nerves, so there was high abnormality in TSEP. Conclusions： TSEP and BR are important methods for evaluating the surrouding structure of trigeminal nerves and the phyiological function of brainstem center conduction ways, and contribute to qualitative and quantitative diagnosis. Because of unstable waveforms, immature technology, strong interference, different stimulating and recording methods,and obscurity in neuroanatomy and electrophysiology, the clinical application of TSEP and BR in ITN are not widly used. Further approaches to their correlation with stimulation, interference, recording method,and standard methodology are necessary.
出处
《癫痫与神经电生理学杂志》
2010年第5期289-292,共4页
Journal of Epileptology and Electroneurophysiology(China)
