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目的 :探索磁刺激运动诱发电位 ( MEP)在颈髓髓内和髓外病变中的诊断价值。 方法 :对 3 7例颈髓病变患者进行前瞻性临床调查 ,包括颈椎病 ( n=2 1) ,颈椎管狭窄症 ( n=6) ,颈椎及颈髓肿瘤 ( n=6)和脊髓空洞症 ( n=4) ,和对照组 2 0例。结果 :3 1例髓外病变者 ,19例 ( 61.3 % )上肢拇展短肌 ( APB)中枢运动传导速度 ( CMCT)异常 ,2 1例 ( 67.7% )下肢胫骨前肌( AT) CMCT异常 ;6例髓内病变者 ,2例 ( 3 3 .3 % ) APB肌 CMCT异常 ,2例 ( 3 3 .3 % ) AT肌 CMCT异常 ,CMCT异常与颈髓压迫影像和上运动神经元受累表现相关。结论 :在髓外病变 ,AT肌 CMCT较为敏感 ;CMCT异常与脊髓压迫影像和上运动神经元受累表现相关 ,MEP检查对颈髓髓内和髓外病损均有重要诊断价值 ,甚至能发现亚临床型病损
Objective: To explore the diagnostic value of magnetic stimulation motor evoked potential (MEP) in intramedullary and extramedullary lesions of cervical spinal cord. Methods: A prospective clinical investigation was performed on 37 patients with cervical spinal cord lesions, including cervical spondylosis (n = 21), cervical stenosis (n = 6), cervical and cervical spinal tumors (n = 6) and syringomyelia (n = 4), and control group 20 cases. RESULTS: In 31 patients with extramedullary lesions, CMCT was abnormal in 19 cases (61.3%) of the APB and 21 cases (67.7%) were abnormal CMCT in the anterior tibialis anterior muscle. In 6 patients with intramedullary lesions, 2 cases (33.3%) had abnormal CMCT in APB muscle and 2 cases (33.3%) had abnormal CMCT in AT muscle. The abnormality of CMCT correlated with the images of cervical spinal cord compression and motor neuron involvement . Conclusion: CMCT is more sensitive to extrameduline lesions than CMCT. The abnormality of CMCT is related to the imaging of spinal cord compression and the involvement of upper motor neurons. MEP has important diagnostic value for cervical intramedullary and extramedullary lesions, Clinical lesions