頭部外傷病人腦幹聽覺誘發電位之變化

Brainstem Auditory Evoked Potentials in Head Injury Patients

潘昭雄(Chou-Hsiung Pan) ； 陳暫如(Tsan-Ju Chen) ； 林國憲(Kwo-Shang Lin) ； 陳順勝(Shun-Sheng Chen)

《The Kaohsiung Journal of Medical Sciences》 5卷10期 (1989/10) Pp. 569-577

https://doi.org/10.6452/KJMS.198910.0569

摘要

本研究乃討論頭部外傷患者，其腦幹聽覺誘發電位〈BAEPS〉之變化，並了解與臨床變數間之相關性。選取25名正常人及頭部外傷患者54名，接受BAEPS檢查。同時患者並接受電腦斷層攝影及評定其昏迷指數，其中22名患者於一個月後接受追蹤檢查。結果發現於頭部外傷急性期時，BAEPS之各波出現率大多數有顯著之降低，而潛時僅右側記錄時的第Ⅲ波呈有意義之延長。22名接受追蹤檢查之患者，其第二次BAEPS之波出現率則已有改善之增家之趨勢。若依昏迷指數9分區分患者，兩組中各波出現率及潛時平均值之比較，並無顯著之差異。而依頭部電腦斷層攝影區分為有腦幹中線移位者與無腦幹中線移位者有顯著之降低。所有異常BAEPS包括全部波型消失、第Ⅰ波消失或潛時延長，以及各波間潛時延長。全部患者出現一種或多種異常BAEPS之比率為48.2%。因此，電腦斷層攝影所顯示之結果，與BAEPS的變化較為一致，即有腦幹中線移位者，BAEPS異常從上橄欖核開始即發生。而昏迷指數則反映大腦半球與腦幹整合後之結果，因而BAEPS變化無法與之完全配合。總之，BAEPS檢查可測知頭部外傷患者有否腦幹受損及功能異常，再配合昏迷指數與電腦斷層攝影，可始頭部外傷之診治更為確切，亦可應用於醫學法律上，判定有無器質性腦幹損傷。

並列摘要

This study was designed to designed to evaluate the alterations in brainstem auditory evoked potentials (BAEPS) in patients with head injuries. BAEPS were recorded of twenty-five normal subjects to serve as control group. Fifty-four patients with head injuries were evaluate prospectively by neurological checkups, the Glasgow coma rating scale, brain CT scans, as well as BAEPS. Among them, Twenty-two patients accepted a follow-up evaluation one month after the first study. In the acute stage, though the significant prolongation of peak latency occurred only in the right peak latency occurred only in the right peakⅢas compared with the control group, the rate of presence decreased significantly in most of the peak waves. There were three main types of abnormality: isoelectric BAEP (13.0%), alterations in peakⅠ(29.6%) and in interpeak latencies (13.0%). The incidence of abnormal BAEPS was 48.2% of 54 patients.

並列關鍵字

BAEP ； head injury ； coma