摘要

Pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs) and conventional electrically-stimulated SEPs (electric SEPs) were examined in 8 patients with syringomyelia who showed various forms of dissociated sensory loss. Unlike clinical examination using a pin or needle, pain SEP is considered to be an objective and quantitative test to investigate functions of peripheral and central sensory pathways responsible for pain-temperature sensation (A delta fibres and the spinothalamic tract). Pain SEPs were abnormal in all patients. The results were generally compatible with the degree of a clinical impairment of pain-temperature sensation. Subclinical abnormality was detected in 3 patients. Electric median nerve SEPs using the scalp reference (Fz) were normal in 6 out of 8 patients. However, anterior and posterior cervical responses using a noncephalic reference were absent or small in 7 patients. Electric SEPs following tibial nerve stimulation were normal in 7 patients. These findings suggest that the function of the ascending fibres through the dorsal columns is intact in most patients, whereas the dorsal horn, where a fixed cervical potential is generated, is impaired. Pain SEPs combined with electric SEPs therefore appear to be extremely useful for investigating physiological function in the sensory pathways in patients who show 'dissociated sensory loss' such as in syringomyelia.

译文

对 8 例脊髓空洞症患者的 CO2 激光刺激 (疼痛 SEPs) 和常规电刺激 SEPs (电刺激 SEPs) 后的疼痛相关体感诱发电位进行了检查,这些患者表现出各种形式的分离性感觉丧失。与使用针或针的临床检查不同, 疼痛 9月被认为是一项客观和定量的测试,用于研究负责疼痛-温度感觉 (δ 纤维和脊髓丘脑束) 的外周和中枢感觉通路的功能。所有患者的疼痛 SEPs 均异常。结果通常与疼痛-温度感觉的临床损伤程度一致。3 例患者检测到亚临床异常。8 名患者中有 6 名使用头皮参考 (Fz) 的正中神经电 SEPs 正常。然而,在 7 名患者中,使用非头颅参考的颈椎前后反应不存在或很小。7 例患者胫神经刺激后的电 SEPs 正常。这些发现表明,在大多数患者中,通过背柱的上行纤维的功能是完整的,而产生固定宫颈电位的背角受损。因此,疼痛 SEPs 与电 SEPs 相结合似乎对于研究那些表现出 “分离感觉损失” 的患者,如脊髓空洞症患者的感觉途径中的生理功能非常有用。

Syringomyelia

骨科 脊柱进行性病变 疾病
概述  :  

脊髓内由于多种原因影响形成管状空腔,称为脊髓空洞症(SM)。其病理特点为脊髓有空洞形成及胶质增生,临床主要症状是受损节段的分离性感觉障碍、下运动神经元障碍、长传导束功能障碍以及营养障碍,临床表现为痛、温觉丧失,但深感觉、轻触觉正常。随着医学的进步,MRI等技术的应用,大多SM都可行手术治疗。 脊髓空洞症术前注意事项 术前训练:①呼吸功能训练:用力深吸气后再缓慢呼气,以增加潮气量,减少肺泡无效腔;指导患者正确咳痰,即先深吸气,声门关闭,

Syringomyelia 英 /sɪ,rɪŋgə(ʊ)maɪ'iːlɪə/            

释义   n. [内科] 脊髓空洞症

例句   Syringomyelia may be diagnosed with magnetic resonance imaging. Surgery to correct the condition that caused the syrinx to form may stabilize or improve a patient's health. 脊髓空洞症可由磁共振成像诊断。通过手术矫正致病因素,能使患者的身体状况趋于稳定或得到改善。


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