Measurement Of Sympathetic Skin Response,Somatosensory,Motor Evoked Potentials And Study On Its Clinical Correlation In Patients With Acute Cerebral Infarction

Objective To investigate the abnormal pattern of sympathetic skin response(SSR),somatosensory evoked potential(SEP)and motor evoked potential(MEP)in patients with acute cerebral infarction and its correlation with clinical presentation of the patients.Methods 94 patients with acute cerebral infarction were divided into three groups:cortical-subcortical,basal ganglia-thalamus and ports group.Barthel index ((BI)and national institute of health stroke scale(MESSS)were studied on the first day after they admitted to hospital,grading was made according to the degree of paralysis as well.SSR,SEP and MEP were performed in all the patients within 3 days after they entered hospital.Results(1)the amplitude of SSR decreased in ipslateral upper limb,the amplitude decreased and the latency was prolonged in ipslateral and contralateral lower limbs.The abnormality rate of SSR in group cortical-subcortical was the highest,and group pons' was the lowest.(2)the abnormality of SSR and disappearance of waveform had positive correlation with degree of paralysis and MESSS,and negative correlation with BI,however, prolonged latency and low amplitude had no correlation with them.(3)the latency of N13,N20 and CCT in ipslateral and contralateral were prolonged obviously compared with normal value.The abnormality rate of SEP in group basal ganglia-thalamus was the highest,and group pons' was the lowest.Mostly or all abnormal SEP located in ipslateral.(4)all the parameters of SEP had no correlation with sensory dysfunction.(5)the abnormal SEP had positive correlation with MESSS, the absent or unclear of N20 had positive correlation with degree of paralysis and MESSS,and negative correlation with BI.Whereas prolonged CCT had no correlation with degree of paralysis,MESSS and BI.(6)different location of infarction had different abnormality rate of MEP.The abnormality rate in group pons was the highest,and cortical-subcortical's was the lowest.(7)the abnormality of MEP had no correlation with pathologic sign.(8)the abnormality and absent wave of MEP had positive correlation with degree of paralysis and MESSS,and negative correlation with BI,the prolonged latency and CMCT did't mean the severity of condition.Conclusions(1)sympathetic reflex activity suppressed after acute cerebral infarction,SSR might be used as an objective index to asses quantitatively the condition of sympathetic nerve function,and might be of diagnostic value in the subclinical autonomic nerve dysfunction.(2)the abnormality of SSR and disappearance of waveform reflected the impairment condition of motor function.(3) SEP reflected the function of central sensory conduction pathway.Patients with no absence of sensory also had abnormality of SEP,suggested that there were subclinical impairment in sensory pathway.Compared with CT/MRI,SEP was more sensitive in detecting subclinical and small infarction.(4)in some extent,SEP might reflect the degree of motor nerve impairment.SEP had actual value in predicting the recovery of motor function.(5)MEP mainly reflected the founction of pyramidal tract.The abnormality rate was high in cerebral infarction which influenced the motor central and motor conduction pathway.Sometimes the absence of MEP did not represent the block of pyramidal tract thoroughly,so pathologic sigh might be negative when MEP was absent.(6)MEP examination had important significance in detecting the degree of nerve impairment.MEP might analyze quantitatively the functional damage of patients and as the early prognostic value of recovery of motor function.