带状疱疹节段性轻瘫的电生理特点分析

Electrophysiological features of patients with segmental zoster paresis

摘要:

目的 分析带状疱疹节段性轻瘫的电生理特点。方法 回顾分析2017年10月至2022年10月肌电图室接诊的11例带状疱疹节段性轻瘫患者神经电生理检查结果。结果 11例患者的电生理结果均异常，神经传导异常率为20.9%（41/196）。运动神经异常率为26.0%（26/100），感觉神经异常率为15.6%（15/96），以受累神经波幅降低为主。与健侧对比，神经传导波幅异常率为18.4%（36/196），其中运动传导波幅异常率为23.0%（23/100），感觉传导波幅异常率为13.5%（13/96）。炎性神经病病因和治疗量表（Inflammatory Neuropathy Cause and Treatment，INCAT）评分与复合肌肉动作电位（compound muscle action potential，CMAP）波幅下降比例最大值呈正相关（P<0.05）。针极肌电图显示受累肌肉呈神经源性损害改变。结论 带状疱疹节段性轻瘫患者的电生理结果分为神经丛型、神经根型、单神经型，以轴索损害为主。神经传导联合针极肌电图检测对带状疱疹节段性轻瘫的早期诊断、肌肉定位、病情的严重程度评估有重要价值。

Abstract:

Objective To investigate the electrophysiological features of patients with segmental zoster paresis.Methods A retrospective analysis was performed for the neural electrophysiological data of 11 patients who attended Electromyography Examination Room from October 2017 to October 2022.Results All 11 patients had abnormal electrophysiological results，and the abnormal rate of nerve conduction was 20.9%（41/196）. The abnormal rates of motor nerve conduction and sensory nerve conduction were 26.0%（26/100） and 15.6%（15/96），respectively，mainly reduction in the amplitude of the nerve involved. Compared with the contralateral side，the ipsilateral side had an abnormal rate of nerve conduction amplitude of 18.4%（36/196），with an abnormal rate of 23.0%（23/100） for motor nerve conduction amplitude and 13.5%（13/96） for sensory nerve conduction amplitude. INCAT score was positively correlated with the maximum reduction ratio of CMAP amplitude（P<0.05）. Needle electromyography showed neurogenic damage in the affected muscles.Conclusion The electrophysiological results of patients with segmental zoster paresis can be classified into nerve plexus type， nerve root type，and single nerve type， and patients mainly have axonal damage. Nerve conduction combined with needle electromyography has an important value in the early diagnosis，muscle localization， and severity assessment of segmental zoster paresis.