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亚急性联合变性为脊髓后侧索的联合变性,临床表现以深感觉障碍和锥体束损害表现为主,常伴周围神经损害,且周围神经症状常在疾病早期即出现,但是靠临床体检不易发现早期的轻度周围神经损害.本文对1例临床确诊的亚急性联合变性患者进行感觉电流阈值(Current Perception Threshold,CPT)测定,发现有较广泛的周围神经轻-中度损害.患者临床查体示双上肢音叉震动党轻度减退,双下肢音叉震动觉明显减退,痛、触觉大致正常.用NEUROMEIER CPT仪对8个位点进行3种频率的正弦波电流刺激,阈值测定结果为:2KHz刺激阈值281-700MA,平均481MA,(正常179-423MA,平均320MA);250Hz刺激阈值183-644MA,平均348.25MA(正常26-183MA,平均125MA);5Hz刺激阈值35-416MA,平均260.5MA(正常18-170MA,平均73MA).结果显示双侧上下肢的Aβ纤维及双上肢的C纤维、Aσ纤维均有轻-中度损害.CPT检查通过不同频率的正弦波电流刺激分别对C纤维、Aβ纤维和Aσ纤维的感觉功能进行定量检测,是一种快速、简便、无痛、无创的测量末梢神经功能的方法,对检测周围神经病变有较高的灵敏度,在亚急性联合变性中可对叠加有后索损害的周围神经病变作出早期诊断并进行动态观察,是临床体检和其它电生理检查所无法做到的.此外CPT检查对其它多种病因引起的周围神经
Subacute combined degeneration into the spinal cord posterior lateral degeneration, clinical manifestations of deep sensory disturbances and pyramidal tract damage performance, often accompanied by peripheral nerve damage, and peripheral neurological symptoms often appear early in the disease, but difficult to find by clinical examination Early mild peripheral nerve damage.In this paper, one case of clinically diagnosed subacute combined degeneration of patients with sensory current threshold (Current Perception Threshold, CPT) determination, found that there is a more extensive peripheral nerve damage - moderate clinical examination The results showed that the vibrational sensation of the lower extremities was significantly reduced and the sensation of pain and tactile sensation was almost normal.Using the NEUROMEIER CPT instrument, sinusoidal current stimulation at three frequencies was performed at 8 sites with the threshold of 2KHz stimulation Threshold 281-700 MA, average 481 MA, normal 179-423 MA, average 320 MA; 250 Hz stimulation threshold 183-644 MA, mean 348.25 MA (normal 26-183 MA, average 125 MA); 5 Hz stimulation threshold 35-416 MA, average 260.5 MA 18-170MA, an average of 73MA) .The results showed that both the upper and lower extremity Aβ fibers and both upper extremity C fibers, Aσ fibers have mild to moderate damage.CPT examination by different frequencies of sine wave current stimulation C fiber, Aβ fiber and Aσ fiber sensory function of quantitative detection, is a fast, simple, painless, noninvasive method of measuring peripheral nerve function, the detection of peripheral neuropathy with high sensitivity in subacute combined degeneration Can be superimposed with the hindpaw damage peripheral neuropathy to make early diagnosis and dynamic observation, clinical examination and other electrophysiological examination can not be done.In addition CPT examination of a variety of other causes of peripheral nerve