【摘要】 目的 :研究经颅电刺激运动诱发电位 (MEP)与脑卒中患者运动功能状态的关系 ,评估MEP对脑卒中病人运动功能恢复的预测价值。方法 :对 5 4例有偏瘫的脑卒中患者在病后 10天内行MEP检查 ,同时作肌力和临床神经功能评分测定 ,并于 10周后对其中的 2 8例复查。正常对照组为 30例健康者。结果 :脑卒中病人急性期MEP的异常率为 89% ,主要表现为MEP缺失 ,潜伏期延长 ,波幅降低或波形异常 ,中枢运动传导时间 (CMCT)延长 ,患侧与健侧及与对照组比较 ,有显著差异 (P <0 0 1)。MEP缺乏者 ,瘫痪重 ;MEP可引出者 ,瘫痪程度轻 ,两者间差异亦显著 (P <0 0 1)。 10周后复查时发现MEP有不同程度的改善 ,这种改善与临床上的功能恢复相一致 ,早期MEP缺乏者 ,功能恢复差 ,早期MEP仅仅波幅低或CMCT延长者 ,其功能恢复好。两者间差异显著 (P <0 0 1)。结论 :MEP可定量分析脑卒中病人运动功能的缺损情况 ,并可作为运动功能恢复的早期预测指标更多还原

【Abstract】 Objective:To observe the correlation between transcranial electrical stimulation motor evoked potential (MEPs) and motor function as well as the predicative value of MEP in motor function recovery in patients with stroke.Methods:Electrical stimulation MEP was performed in 54 patients with stroke within 10 days after stroke. Initial muscle strength and outcome of neurologic deficit were determined as well.A clinical follow-up was done in 28 out of total 54 patients after 10 weeks. Thirty normal subjects were served as control.Results:The abnormality rate of MEP in acute stage was 88.9%,mainly showing the disappearance of MEP, prolongation of latency of cortical MEP and central motor conduction time (CMCT),decreace of amplitude and abnormality of waveforms. A significant difference was noted as compared with the normal side and the normal subjects (P<0.01). The abnormal degrees of MEP were closely correlated with the patients’ clinical symptoms, patients who showed absence of MEP had severe hemiparesis,but patients with MEP showed mild motor deficit, and the difference between them was significant.Improvement of MEP with different degree was observed 10 weeks after stroke, this improvement was correlated with the functional recovery,the patients with MEP showed better motor functional recovery than those without it (P<001)Conclusions:MEP could quantitatively analyze the degree of the motor function deficit of the patients with stroke, and it might be of early predicting index for motor function recovery.更多还原