摘要
目的 探讨临床和神经电生理检查对于多系统萎缩 (MSA)的诊断价值。方法 对 44例MSA患者分组分析其临床特点、肌电图 (EMG)、神经传导速度 (NCV)、躯体感觉诱发电位 (SEP)、运动诱发电位 (MEP)、脑干听觉诱发电位 (BAEP)及视觉诱发电位 (VEP)。并比较临床表现和电生理检查结果在各组间的差异。结果 本组患者以自主神经功能障碍和小脑性共济失调的异常率最高(88 6 % )。帕金森综合征出现率在各组间差异有显著意义 (P值分别为 0 0 2 7、0 0 0 7、0 0 2 5) ,卧立位血压异常在拟诊组和可能组间差异有显著意义 (76 5 %、1 8 2 % )。EMG和NCV的异常率为38 1 % ,各组间出现率有不同。各种诱发电位的异常出现率在分组比较中无显著性差异。结论 仅凭临床表现无法对MSA进行分组。各项神经电生理检查中以BAEP的阳性率最高。
Objective To identify the clinical and neurophysiological features of multiple system atrophy (MSA) and explore diagnostic values using various techniques in electro neurophysiology Methods Forty four subjects diagnosed as multiple system atrophy (MSA) during 1983 to 2001 in PUMC Hospital were studied retrospectively about their clinical features, routine electromyography (EMG), nerve conductive velocity (NCV), somatosensory evoked potential (SEP), motor evoked potential (MEP), brainstem auditory evoked potential (BAEP) and visual evoked potential (VEP) The clinical features and the electroneurophysiologic results were analyzed in different subgroups (probable MSA and possible MSA, OPCA and non OPCA, classified MSA and unclassified MSA) Results Most patients were found to be suffered from autonomic failure (88 6%) and cerebella dysfunction (88 6%) The pyramidal sign was seen in 72 7% of patients No remarkable statistical differences were found in all of the above three domains The incidence of Parkinsonism was 36 4% of all the patients, which showed significant differences between probable and possible MSA (54 5% vs 18 2%), non OPCA and OPCA (50% vs 7 1%), unclassified MSA and classified MSA (52% vs 15 8%) EMG was abnormal in 7 patients (38 1%), all of them were neurogenic impairments The rates of abnormal EMG were varied differently between probable and possible MSA (54 5% vs 22 2%), non OPCA and OPCA (53 8% vs 14 3%), unclassified MSA and classified MSA (58 3% vs 12 5%), but without statistical differences The abnormal rates in BAEP,SEP, VEP and MEP were 56 7%, 28%, 23 1% and 20 0%, respectively, and there were no significant differences between subgroups Conclusions It should be hard to divide MSA into groups only by the clinical manifestations All EPs were abnormal in some extent The most sensitive test is BAEP in current study, but there were no differences among the subgroups in the rates of abnormal EPs The difference of EMG and NCV between the groups showed that the technique might be helpful in the diagnosis of MSA
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2003年第2期94-97,共4页
Chinese Journal of Neurology
