張楊全2006-07-262018-07-122006-07-262018-07-121998http://ntur.lib.ntu.edu.tw//handle/246246/26069多發性神經病變多為代謝障礙、營養 缺乏、中毒、自體免疫失常、血中蛋白異 常或癌症等全身性疾病之一種臨床表徵。 若能仔細地分析神經傳導檢查之結果，當 有助於探索多發性神經病變之可能病因。 　本研究共收集128位正常人，19位急性 脫髓鞘性多發性神經病變（ADP）患者，36 位慢性脫髓鞘性多發性神經病變（CDP）患 者及16位糖尿病神經病變患者，針對其右 側前臂段之正中神經施予不同之周邊神經 傳導評估。所採用之檢查方法為： 一、刺激正中神經而在短外展姆肌記錄運 動動作電位之運動神經傳導。 二、刺激正中神經而在食指記錄感覺動作 電位之感覺神經傳導。 三、刺激正中神經遠端而在正中神經近端 記錄神經動作電位之神經傳導。 四、刺激正中神經近端而在正中神經遠端 記錄神經動作電位之神經傳導。 五、分別刺激正中神經遠端及近端之頭皮 記錄體覺誘發電位所得之神經傳導。 結果顯示，刺激運動纖維所得之神經 傳導速度（NCV）比其他四種方法所得者 低。在ADP患者中，記錄神經動作電位的NCV 未有明顯改變外，其他四種方法之NCV皆有 下降之趨勢。在CDP患者中，所有方法所得 之NCV皆比正常組明顯下降，而且和正常人 維持相常的分佈趨勢。Careful nerve conduction studies in patients with polyneuropathy can provide useful information for differential diagnosis of the pathophysiological processes and in search of their underlying etiological factors. We systematically studied nerve conduction velocities of the right median nerve with different techniques in 128 normal controls, 19 patients with acute demyelinating polyneuropathy, 36 patients with chronic demyelinating polyneuropathy, and 16 patients with diabetic polyneuropathy. Techniques to study the nerve conduction of the median nerve included motor nerve conduction with measuring the latency of evoked compound muscle action potentials;. sensory nerve conduction with measuring the latency of evoked sensory action potentials; centripetal nerve conduction with measuring the latency of the centripetally recorded nerve action potential; centrifugal nerve conduction with measuring the latency of the centrifugally recorded nerve action potentials; nerve conduction by measuring the latencies of scalp somatosensory evoked potentials to stimulation of the median nerve distally and proximally. We found that nerve conduction velocity (NCV) through motor fiber stimulation was slower than that through any other techniques. In the patients with acute demyelinating polyneuropathy, NCV through centrifugally recorded technique did not slow significantly as compared with that in the normal controls. NCVs from other diagnostic techniques were lower than those in the normal controls. In chronic demyelinating polyneuropathy, NCV obtained from any electrodiagnostic technique was slower than the NCV with comparable technique in the normal controls. The normal controls and the patients with chronic demyelinating polyneuropathy had a same pattern of NCV difference among various electrodiagnostic techniques.application/pdf48999 bytesapplication/pdfzh-TW國立臺灣大學醫學院神經科多發性神經病變運動神經傳導檢 查感覺神經傳導檢查體覺誘發電位polyneuropathynerve conduction studynerve action potentialsomatosensory evoked potential[SDGs]SDG3journal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/26069/1/872314B002052.pdf