アブストラクト
Japanese
Title | 臨床に役立つ神経伝導検査の実際 |
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Subtitle | 第37回日本神経治療学会総会特集1 メディカルスタッフレクチャー2 |
Authors | 逸見祥司** |
Authors (kana) | |
Organization | **川崎医科大学神経内科学教室 |
Journal | 神経治療学 |
Volume | 37 |
Number | 3 |
Page | 287-290 |
Year/Month | 2020 / |
Article | 報告 |
Publisher | 日本神経治療学会 |
Abstract | 「はじめに」 手足の筋力低下やしびれ感のため筋電図外来へ紹介される患者は非常に多い. そのなかには診断が必ずしも容易ではないものがあり, 的確な診察と検査を行って正しい結論を導き出す能力が求められる. まず, 病歴や臨床症候からおおよその病態をつかみ, その診察所見をもとに必要な検査を計画する. その際, 神経伝導検査(nerve conduction study : NCS)など電気生理学的検査は, あくまでもベットサイド診察で得た所見を補完する目的で行うことを理解しておく. 問診では, いつ, どのように発症したか, ポイントを押さえた病歴聴取を行う. 責任病巣を絞り込むうえで徒手筋力検査(manual muscle testing : MMT), 筋萎縮, 感覚障害の分布, 腱反射, 病的反射の評価が役立つ(画像診断だけに頼らない). 運動麻痺が筋節や末梢神経の支配筋に限局していれば, 「中枢性」よりも「末梢性」麻痺(下位運動ニューロン障害)の可能性が高まる. |
Practice | 臨床医学:内科系 |
Keywords | electrodiagnosis, nerve conduction study, compound muscle action potential, sensory nerve action potential, conduction block |
English
Title | Practice of nerve conduction studies useful for clinical diagnosis |
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Subtitle | |
Authors | Shoji HEMMI |
Authors (kana) | |
Organization | Department of Neurology, Kawasaki Medical School |
Journal | Neurological Therapeutics |
Volume | 37 |
Number | 3 |
Page | 287-290 |
Year/Month | 2020 / |
Article | Report |
Publisher | Japanese Society of Neurological Therapeutics |
Abstract | Nerve conduction studies (NCSs) are essential for diagnosis of peripheral neuropathy. NCSs should be performed for the purpose of complementing the findings obtained by detailed neurological examinations. If weakness or numbness is consistent with the territory innervated by a peripheral nerve or spinal nerve, it is more likely to be a peripheral lesion than a central lesion. A fibular NCS is useful for the diagnosis of foot drop. The compound muscle action potential (CMAP) of the fibular nerve is usually recorded on the extensor digitorum brevis, but the CMAP is susceptible to potential damage and may not be suitable for the evaluation of foot drop. In that case, it is recommended to record the CMAP on the tibialis anterior. Sensory conduction studies can distinguish lesions before and after the dorsal root ganglion (L5 radiculopathy vs. fibular neuropathy). It should be noted that conduction block and temporal dispersion are not always demyelinating findings. |
Practice | Clinical internal medicine |
Keywords | electrodiagnosis, nerve conduction study, compound muscle action potential, sensory nerve action potential, conduction block |
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参考文献
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