南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2009年
12期
2437-2441
,共5页
不典型重症肌无力%临床表现%低频重复神经电刺激
不典型重癥肌無力%臨床錶現%低頻重複神經電刺激
불전형중증기무력%림상표현%저빈중복신경전자격
atypical%myasthenia gravis%clinical symptoms%low fiequency repetitive nerve stimulation
目的 研究不典型重策症肌无力患者的临床表现及其电生理的变化.方法 回顾性分析自2004年1月～2008年12月以来到我院就诊的32例不典型重症肌无力患者的临床特点及电生理异常的特征.结果 全组年龄7～70岁.单纯眼肌型5例,其中2例仅有眼睛不适或视物模糊感.全身型27例,其中6例表现为四肢乏力或者伴有轻度吞咽、呼吸肌的受限无眼肌、头颈、面肌的障碍.2例患者有肌肉萎缩.全组中症状有晨轻暮重及波动性表现且疲劳试验阳性的有23例,占71.9%;新斯的明试验阳性者29例,占90.6%.重复频率神经刺激:眼肌型患者中,低频刺激阳性的2例,阳性率40.0%;全身型患者中,低频刺激阳性的21例,阳性率77.8%.全组低频刺激总阳性率71.9%,与文献报道一致.结论 一些临床表现不典型,疲劳试验阴性和新斯的明试验呈阴性的重症肌无力患者,肌电图低频刺激仍可作为一项不可或缺的重要辅助检查手段,提高重症肌无力的检出率,减少漏诊误诊.
目的 研究不典型重策癥肌無力患者的臨床錶現及其電生理的變化.方法 迴顧性分析自2004年1月～2008年12月以來到我院就診的32例不典型重癥肌無力患者的臨床特點及電生理異常的特徵.結果 全組年齡7～70歲.單純眼肌型5例,其中2例僅有眼睛不適或視物模糊感.全身型27例,其中6例錶現為四肢乏力或者伴有輕度吞嚥、呼吸肌的受限無眼肌、頭頸、麵肌的障礙.2例患者有肌肉萎縮.全組中癥狀有晨輕暮重及波動性錶現且疲勞試驗暘性的有23例,佔71.9%;新斯的明試驗暘性者29例,佔90.6%.重複頻率神經刺激:眼肌型患者中,低頻刺激暘性的2例,暘性率40.0%;全身型患者中,低頻刺激暘性的21例,暘性率77.8%.全組低頻刺激總暘性率71.9%,與文獻報道一緻.結論 一些臨床錶現不典型,疲勞試驗陰性和新斯的明試驗呈陰性的重癥肌無力患者,肌電圖低頻刺激仍可作為一項不可或缺的重要輔助檢查手段,提高重癥肌無力的檢齣率,減少漏診誤診.
목적 연구불전형중책증기무력환자적림상표현급기전생리적변화.방법 회고성분석자2004년1월～2008년12월이래도아원취진적32례불전형중증기무력환자적림상특점급전생리이상적특정.결과 전조년령7～70세.단순안기형5례,기중2례부유안정불괄혹시물모호감.전신형27례,기중6례표현위사지핍력혹자반유경도탄인、호흡기적수한무안기、두경、면기적장애.2례환자유기육위축.전조중증상유신경모중급파동성표현차피로시험양성적유23례,점71.9%;신사적명시험양성자29례,점90.6%.중복빈솔신경자격:안기형환자중,저빈자격양성적2례,양성솔40.0%;전신형환자중,저빈자격양성적21례,양성솔77.8%.전조저빈자격총양성솔71.9%,여문헌보도일치.결론 일사림상표현불전형,피로시험음성화신사적명시험정음성적중증기무력환자,기전도저빈자격잉가작위일항불가혹결적중요보조검사수단,제고중증기무력적검출솔,감소루진오진.
Objective To study the clinical characteristics and electrophysiological changes in patients with atypical myasthenia gravis (MG).Methods The characteristics of the clinical symptoms and electrophysiological changes were.investigated in 32 patients with atypical MG diagnosed in our hospital fi'om January 2004 to December 2008.Results The ages of the patients ranged from 7 to 70 years.Five patients were diagnosed to have ocular MG (OMG), among whom 2 patient only complained of eye discomfort and blurred vision.Twenty-seven patients had generalized MG, and 6 of them showed muscle weakness of the limbs with or without mild difficulty in swallowing or respiratory muscles, but flee of muscle dysfunctions in muscles of eyes, head, neck or face.Another 2 patients manifested muscular atrophy.Twenty-three patients (71.9%) displayed both fluctuating symptoms and positive results of fatigue test.Twenty-nine patients (90.6%) have positive results in the neostigmine test.Two patients in the OMG group (40.0%) showed positive results in the low frequency repetitive nerve stimulation (LFRNS), as compared with the 21 patients in the generalized MG group (71.9%) showing positive results.The total positivity rate of LFRNS was 71.9% in the total patients, consistent with the published data.Conclusion In MG patients with atypical clinical symptoms, negative results of neostigmine test and fatigue test, LFRNS test can be an indispensable method to increase detection rate of MG and reduce erroneous or missed diagnosis.
