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本研究观察了20例正常小儿和49例脑瘫小儿的下肢胫后神经刺激性短潜伏时头皮体感诱发电位(PTN-SSEP)。正常小儿在刺激后出现6个反应波(P18、N23、P31、N42、P54和N68),大脑左右两体感头皮的SSEP波形相似;时相基本相等,t检验表明两侧间无差异;电压除波P31外其余波也无显著差异。脑瘫小儿PTN-SSEP异常率达91.84％,有4种类型:正常型占8.16％、混合异常型57.14％、反应低下型6.12％及电压不对称型28.57％。经统计患儿左右头皮的SSEP、潜伏时和电压均有显著差异(P<0.05),其中P31和N42电压差值>50％。与正常小儿比较,患儿双侧反应降低,多数波潜伏时延长。患侧电压损失率>50％(P<0.001),波P18、N23和P31的潜伏时差异显著。结果提示.(1)正常小儿体感通路反应稳定,左右侧活动基本对称;(2)脑瘫小儿体感通路左右侧活动不对称,患侧传导机能下降,体感皮层反应减退。
This study was designed to investigate the PTN-SSEP of 20 normal children and 49 children with cerebral palsy under short latency after posterior tibial nerve stimulation. Six normal waveforms (P18, N23, P31, N42, P54 and N68) appeared in normal children after stimulation. The SSEP waveforms of the left and right brains of the left and right brains were similar. The time phases were basically the same, t test showed no difference between the two sides; Wave P31 outside the rest of the wave nor significant difference. The abnormal rate of PTN-SSEP in children with cerebral palsy was 91.84%. There were 4 types of abnormal PTN-SSEP in children with cerebral palsy: 8.16% of normal type, 57.14% of mixed abnormal type, 6.12% of low response type and 28.57% of unsymmetrical voltage type. The SSEP of left and right scalp in children were statistically significant (P <0.05), and the voltage difference between P31 and N42 was> 50%. Compared with normal children, children with bilateral response decreased, most of the latency latency. Ipsilateral voltage loss rate> 50% (P <0.001), wave P18, N23 and P31 significant differences in latency. The results suggest that: (1) normal children somatosensory pathway response is stable, left and right side of the basic symmetry of activity; (2) cerebral palsy somatosensory pathway left and right asymmetric activity, reduced ipsilateral conduction function, somatosensory cortical response decreased.