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目的研究三叉神经-颈反射(TCR)在Chiari畸形中术前临床诊断及术后疗效的评测。方法2003年12月至2005年1月我院神经内外科门诊和病房收治的经磁共振成像(MRI)确诊的30例ChiariⅠ畸形患者。术前及术后(20~25d)行TCR检查,观察P19潜伏期、N31潜伏期、A值(取波幅比率的平方根)以及波形。结果本组30例患者术前TCR异常率为90%(与MRI结果基本吻合)。具体表现为TCR的P19、N31潜伏期延长、A值及两侧差增大、波形消失;术后80%的患者TCR检查P19、N31的潜伏期基本恢复至正常范围,波形消失者波形复现。本组MRI结果为100%的改善。结论TCR能够比较准确、完整地反映颈延髓区功能,在Chiari畸形的诊断中是除MRI以外可以借鉴使用的一种新型神经电生理检查方法。
Objective To study the preoperative clinical diagnosis and postoperative efficacy of trigeminal nerve-neck reflex (TCR) in Chiari deformity. Methods Thirty patients with Chiari Ⅰ malformation diagnosed by magnetic resonance imaging (MRI) from December 2003 to January 2005 in our hospital were collected. Preoperative and postoperative (20 ~ 25d) TCR examination was performed to observe the latency of P19, the latency of N31, the value of A (taking the square root of the amplitude ratio) and the waveform. Results The abnormal rate of preoperative TCR in 30 patients was 90% (basically consistent with MRI findings). Specifically, the latency of P19 and N31 in TCR was prolonged, the value of A and the difference in both sides increased, and the waveform disappeared. The incubation period of P19 and N31 in TCR examination returned to the normal range in 80% of the patients after operation. This group of MRI results for the 100% improvement. Conclusion TCR can reflect the function of cervical medulla oblongata more accurately and completely. It is a new neuroelectrophysiological method that can be used for reference besides MRI in the diagnosis of Chiari malformation.