Chiari畸形或/和脊髓空洞病人的SEPs变化模式和临床意义

以南京大学医学院1997年7月至2003年3月间收治的70例Chiari畸形／脊髓空洞症患的体感诱发电位的变化，探讨体感诱发电位在该病早期的诊断价值，对70例患进行双侧上下肢正中神经和胫后神经体感诱发电位检测．70例患中胫后神经SEPs检查有24例(34．3％)异常，其中Chiari畸形组2例，脊髓空洞组7例，Chiari畸形伴脊髓空洞组15例,70例患中正中神经SEPs检查有15例(21．4％)异常，其中Chiari畸形组1例，脊髓空洞组4例，Chiari畸形伴脊髓空洞组10例，胫后神经SEPs检查较正中神经SEPs更为敏感．常规SEPs能反应深感觉障碍，提示疾病的病损程度，但对Chiari畸形／脊髓空洞的早期诊断帮助不大。

Analysis of SEPs Change Patterns and Clinical Significance in Patients with Chiari Malformation and/or Syringomyelia

This paper analyzed the somatosensory evoked potentials(SEPs)monitoring results of70patients from1997to2003and observed the SEPs changes in Chiari malformation and syringomyelia to study their early diagnostic value.Somatosensory evoked potentials to median and posterior tibial nerve stimulation were obtained in70patients with Chiari malformation and syringomyelia.Abnormal posterior tibial SEPs were found in24(34.3%)patients(including2patients with Chiari malformation,7patients with syringomyelia and15patients with Chiari malformation accompanied by syringomyelia.Abnormal median SEPs were found in15(21.4%)patients(including1patient with Chiari malformation,4patients with syringomyelia and10patients with Chiari malformation accompanied by syringomyelia.Results of both tests were abnormal in fourteen patients with loss of deep sensations.Posterior tibial nerve SEPs proved to be more sensitive than median nerve SEPs.SEPs abnormalities were not correlated with the duration of symptoms.Patients with loss of deep sensations often had abnormal SEPs.