뇌졸중 환자의 정중신경자극 체감각 유발전위반응

Abstract

Median nerve somatosensory evoked potentials (SSEPs) were studied in 98 cases of cerebrovascular disease(CVD), and compared with the SSEPs of 100 healthy subjects. According to the clinical and radiological (brain CT and/or MRI) findings, the patients were divided into four groups ;21 cases with brainstem lesion, 33 with thalamic lesion, 32 with subcortical lesion, and 12 with cortical lesion. Comparing with the results of SSEPs obtained from 100 cases of normal subjects, abnorrnal SSEPs were found 7 of 21 patients in brainstem lesion, 17 of 33 in thalamic lesion, 15 of 32 in subcortical lesion, and 9 of 12 in cortical lesion. There are no statistical significance betueen the lesion site and rate of abnormal SSEPs findings. The 48 patients of CVD exihibited abnormal findings with the patterns of(1) absence ol conical responses in 32 cases(32.7%), (2)decreasing the ratio of amplitude between non-affected and affected cortex in 21 cases (21.4%), (3) prolonged inter-peak latency (IPL) between P/Nl3-N19 in 10 cases(10.2%), (4)distorted shapes in 8 cases(8.7%), and (5) low amplitudes of affected cortical potentials in 6 cases (61%). There were 9 cases who revealed abnormally high amplitude of cortical potentials over the non-affected hemisphere. These findings are suggesting that alteration of amplitude are more prominent than prolonged IPL between P/Nl3-Nl9 in SSEPs of CVD. The changes of SSEPs look more related to the deficit position and vibration sense rather than the pin-prick.