雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 40, Issue 4 （April 1988）

Brain and Nerve 脳と神経 40巻4号（1988年4月発行）

Japanese English

原著

植物状態患者における各種誘発電位測定とCT所見について CLINICOPHYSIOLOGICAL STUDY OF MULTIMODALITY EVOKED POTENTIALS AND COMPUTED TOMOGRAPHIC FINDINGS IN PERSISTENT VEGETATIVE STATE 中村芳樹 ¹ , 中務正志 ¹ , 井端由紀郎 ¹ , 八巻孝夫ジョゼー ¹ , 大平貴之 ¹ , 高瀬守一朗 ² , 峯徹 ³ , 戸谷重雄 ¹ Yoshiki Nakamura ¹ , Masashi Nakatsukasa ¹ , Yukiro Ibata ¹ , Jose Takao Yamaki ¹ , Takayuki Ohira ¹ , Moriichiro Takase ² , Toru Mine ³ , Shigeo Toya ¹ ¹慶應義塾大学脳神経外科 ²慶應義塾大学中央検査部脳波室 ³足利赤十字病院脳神経外科 ¹Departments of Neurosurgery School of Medicine, Keio University ²Departments of Clinical Neurophysiology, School of Medicine, Keio University ³Department of Neurosurgery, Ashikaga Red Cross Hospital pp.341-350

発行日 1988年4月1日 Published Date 1988/4/1

DOI https://doi.org/10.11477/mf.1406206086

PDF(7354KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　抄録　植物状態患者において，各種誘発電位測定による電気生理学的な検討を行い，CTによる形態学的観察との比較検討を加えた。対象は厚生省班研究の基準を満たす植物状態患者（persistent vegetativestate, PVS）22例であり，原因疾患の内訳は，脳動脈瘤破裂3例，脳内出血5例，脳梗塞6例，頭部外傷3例，低酸素症4例，脳腫瘍1例であった。誘発電位として聴性脳幹反応（auditory brainstem response, ABR）短潜時体性感覚誘発電位（short latency somatosensory evoked potential, SSEP）視覚誘発電位（visualevoked potential, VEP）の測定を行い，同時期に施行したCT所見とともに，太田らのPVSの重症度分類ごとに比較検討した。結果は①ABRに比べ，SSEP, VEPはPVSの重症度をより良好に反映していた。②CT所見では，脳室拡大よりも上部脳幹萎縮および異常低吸収域の存在の有無が重症度の指標として有用であった。

The auditory brainstem response (ABR), short latency somatosensory evoked potential (SSEP) and visual evoked potential (VEP) of patients in the persistent vegetative state (PVS) are reported, and the correlations between the electrophysiolo-gical findings and the CT scan findings with the three clinical grades of the PVS (transitional, incomplete and complete vegetative syndromes) are discussed.

Twenty two patients in a vegetative state cau-sed by subarachnoid hemorrhage (3), hypertensiveintracerebral hemorrhage (5), cerbral infarction (6), head injury (3), cerebral anoxia (4) and brain tumor (1).

Each evoked response was evaluated for the presense or absence of abnormalities and assigned a grade ranked I to III. Briefly an evoked re-sponse was assigned a grade I, II,III if it satisfied the respective criteria of normal, moderately abnormal and severely abnormal or absent electri-cal activity.

On the other hand CT scan findings in the PVS were evaluated for abnormal low density areas, ventricular dilatation and enlargement of the sulci and cisterns indicative of atrophy of the brain parenchym.

SSEP and VEP were better correlated with the clinical grade than ABR, and upper brainstem atrophy and abnormal low density area in CT scan findings were more valuable as an index to expresses the clinical features than ventricular dilatation.

On the basis of these results, it is concluded that studies of ABR, SSEP and VEP associated with CT scan findings in the PVS could be a useful diagnostic aid to evaluate the lesions of these patients.