Japanese

Title	臨床に役立つ神経伝導検査の実際
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
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

• 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。

参考文献