神经电生理在脊髓硬脊膜动静脉瘘与视神经脊髓炎谱系疾病中的鉴别诊断价值

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中图分类号：R741 文献标志码：A

Differential diagnostic value of neuroelectrophysiology in spinal dural arteriovenous fistula and neuromyelitis optica spectrum disorder

MA Rundong，MA Wei

（1.Department of Neurology，The First Affiliated Hospital of University of South China， Hengyang 421ooo，China；2. Puai Medical College，Shaoyang University， Shaoyang 422000，China）

Abstract： Objective To explore the diferential diagnostic value of evoked potentials （EPs）and electromy -ography（EMG）in spinal dural arteriovenous fistula（SDAVF） and neuromyelitis optica spectrum disorder （NMOSD）. MethodsData from 6 patients with SDAVF and 22 patients with NMOSD were analyzed. Comparisons were made regarding visual evoked potential（VEP），brainstem auditory evoked potential （BAEP），somatosensory evoked potential（SEP）of both upper and lower limbs，motor and sensory nerve conduction studies of the lower limbs，tibial nerve F-wavesand H-reflexes，and needle electromyography findings.Results Statistically significant diffrences between SDAVF and NMOSD patients were observed in VEP，tibial nerve F-waves，and needle electromyography （ P <0.05）.No significant differences were found in BAEP，SEP of both upper and lower limbs，motor and sensory nerve conduction studies of the lower limbs，or tibial nerve H-reflexes （ P >0.05）. Conclusion VEP， tibial nerve F- waves，and needle electromyography have differential diagnostic value in SDAVF and NMOSD，whereas BAEP， SEP of both upper and lower limbs， motor and sensory nerve conduction studies of thelower limbs，and tibial nerve H-reflexes show no significant differential diagnostic value in the two diseases.

Key words： spinal dural arteriovenous fistula； neuromyelitis optica spectrum disorder； evoked potent-ials； electromyography

脊髓硬脊膜动静脉瘘（spinal dural arteriovenous fistula，SDAVF）是一种与脊髓血管畸形相关的常见疾病，占所有脊髓血管病变的 50%～80% ，其最常累及胸腰椎区域，发病率低，起病隐匿，临床无典型症状，一旦出现脊髓水肿和坏死，即可出现进展性的神经功能障碍[1]距离SDAVF的首次描述已过去近100年，但其临床诊断仍具挑战性，超过 60% 的SDAVF患者被误诊，因其影像学表现与其他多种形式的脊髓炎相似，表现为长节段脊髓病的SDAVF往往被误诊为视神经脊髓炎谱系疾病（neuromyelitis optica spectrum disorder，NMOSD）[2]。（剩余7951字）