<原著>錐体路障害患者の上肢H波とその臨床的意義
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概要
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The hand H-wave which is generally difficult to elicit in the normal person could be recorded in the patients with pyramidal tract disorders. The materials used were 22 patients (11 cerebrovascular diseases, 10 brain tumors and 1 brain contusion ) who all presented srastic paralysis in the upper extremities. The control study was performed upon 25 normals and 10 Parkinsonian rigid patients. The muscle tested were m. abductor pollicis brevis and m. flexor carpi radialis. The recording electrodes were placed at the muscle bellies. The median nerve was stimulated at the wrist and in the cubital fossa, and electrostimulus tetanization of 200 Hz. frequency was also tried. In 20 normals examined, the H-wave could not be elicited in m. abductor pollicis brevis, and in only 6 cases of the normals it was demonstrated after tetanization, being diminished soon. Whereas in 9 cases of the 22 patients the H-wave could be elicited, which was not attenuated with the M-wave augmentation by increasing stimulus intensity. When tetanization was performed, the typical H-wave was elicited clearly in 11 of the 13 spastic patients who did not show the H-wave initially, and the H-wave thus elicited kept plateau level of its amplitude for a while, then diminished gradually. This H-wave was not attenuated with the M-wave augmentation. No H-wave could be elicited in the 10 cases of Parkinsonian rigid patients. On the other hand, in normal m. flexor carpi radialis the H-wave was demonstrated in 20 of the 25 cases. It was recorded in the 4 cases with severe spastic paralysis of long duration, and the H-wave was not attenuated with the M-wave augmentation. Thus, the conduction velocity of afferent nerve was slower thara that of the efferent. Therefore it is considerable that the antidromic impulse should not collide with orthodromic one in the efferent nerve. The easy recordability of H-wave of the spastic patients could be considered to be caused by the deficits of inhibition to reflex and by the slowness of conduction velocity. This examination reported here might be a proper method for the patients to evaluate their diagnosis and rehabilitation.
- 近畿大学の論文
- 1988-03-25
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