Kev Ntsuas Peev Xwm Uas Tau Ua Rau Muaj Teeb Meem (VEP, BAEP, SSEP, MEP): Nws Ntsuas Dab Tsi Thiab Nws Ua Tsis Tau Dab Tsi

Tus yuam sij takeaways

• Ua rau muaj kev ntsuas kev sim uas muaj peev xwm ua tau kev sib txuas lus raws txoj kev, tsis yog anatomy, MRI qhia cov qauv, evoked potentials qhia kev ua haujlwm.
• Txhua hom tsuas yog sim ib txoj kev xwb: VEP txoj kev pom, BAEP txoj kev hnov ​​thiab lub hlwb, SSEP txoj kev hnov ​​​​​​lus ntawm tus txha caj qaum, MEP txoj kev tsav tsheb.
• Ib qho peev xwm tshwm sim ib txwm tsis suav nrog ntau yam sclerosis, mob pob txha caj qaum lossis kev hnov ​​​​lus tsis zoo.
• Yog tias qhov tshwm sim tsis zoo qhia tau tias txoj kev ua haujlwm tsis zoo; nws tsis qhia qhov ua rau, uas yuav tsum tau soj ntsuam thiab feem ntau yog thaij duab.
• Kev npaj, lub sijhawm ntev thiab kev tshaj tawm txawv ntawm cov chav kawm neurophysiology; koj chav kawm cov lus qhia sau ua ntej.

Ib nrais muag

Kuj hu ua

• Kev xeem EP, kev xeem teb rov qab los
• Kev xeem VEP / kev teb pom kev
• BERA (brainstem evoked response audiometry), ABR, BAEP, feem ntau hu ua "kev ntsuam xyuas kev hnov ​​lus rau cov menyuam mos" hauv Is Nrias teb
• SSEP / SEP, "kev kuaj mob ntawm cov hlab ntsha"
• MEP, feem ntau ua raws li kev txhawb nqa magnetic transcranial motor evoked potentials
• Hais txog qee lub chaw kuaj mob hauv Is Nrias teb raws li "EP kev tshawb fawb" lossis "evoked potential study (tag nrho plaub hom kev kawm)"

Qhov kev sim ua tau yog dab tsi

Ib qho kev sim uas muaj peev xwm tshwm sim yog ib pawg ntawm kev sim neurophysiology. Ib qho kev txhawb zog raug rov ua dua ntau zaus thaum cov electrodes ntawm lub taub hau, thiab qee zaum hla lub caj dab, tus txha nraub qaum lossis ib ceg, sau cov kev hloov pauv me me ntawm lub zog uas ua raws. Lub khoos phis tawj suav nruab nrab ntau pua qhov kev teb kom lub teeb liab sawv tawm ntawm keeb kwm yav dhau los ntawm lub hlwb.

Cov ntaubntawv kaw suab tsim ib lub waveform nrog cov peaks tshwj xeeb. Ob qhov kev ntsuas tseem ceeb tshaj plaws: latency , qhov qeeb ntawm stimulus thiab peak, thiab amplitude , qhov loj ntawm peak. latency qeeb feem ntau qhia txog demyelination, kev puas tsuaj rau lub insulating sheath ntawm cov hlab ntsha fibers. Qhov amplitude txo qis feem ntau qhia txog kev poob ntawm cov hlab ntsha fibers lawv tus kheej, txawm hais tias ob qho tib si sib tshooj.

Lub peev xwm pom tau (VEP)

Tus neeg saib ib daim duab chequerboard uas tig rov qab ntawm lub vijtsam nrog ib lub qhov muag npog, tom qab ntawd lwm qhov. VEP ntsuas cov hlab ntsha optic thiab txoj kev pom mus rau occipital cortex. Flash VEP siv thaum tus neeg mob tsis tuaj yeem ntsia ntsoov rau ntawm ib daim duab, thiab muab cov ntaub ntawv tsis meej.

Lub peev xwm hnov ​​​​​​lus ntawm lub hlwb (BAEP / BERA / ABR)

Cov suab nias raug xa los ntawm lub mloog pob ntseg thiab cov lus teb los ntawm cochlea, cov hlab ntsha auditory thiab brainstem raug kaw. BERA yog siv dav hauv kev ntsuam xyuas kev hnov ​​​​lus ntawm cov menyuam mos thiab cov menyuam mos thiab hauv cov kev xav tias muaj cov kab mob retrocochlear.

Lub peev xwm ntawm Somatosensory (SSEP)

Ib lub zog hluav taws xob me me raug siv rau ntawm lub dab teg (cov hlab ntsha nruab nrab) lossis pob luj taws (cov hlab ntsha sab nraub qaum tibial). SSEP ua raws li txoj kev hnov ​​​​​​lus fiber loj los ntawm cov hlab ntsha peripheral, cov kab dorsal ntawm cov hlab ntsha caj qaum, lub hlwb thiab lub cortex hnov ​​​​​​lus.

Lub zog ua rau lub cev muaj zog (MEP)

Kev siv hlau nplaum los yog hluav taws xob los txhawb lub cev muaj zog ua rau cov leeg nqaij teb tau los ntawm ib ceg. MEP ntsuas txoj kev corticospinal (tsav zog) thiab feem ntau yog siv rau hauv cov chaw kho mob hlwb tshwj xeeb thiab thaum phais mob caj dab lossis hlwb. MEP yuav tsum tau kuaj xyuas kev nyab xeeb rau tus kab mob qaug dab peg, cov khoom siv plawv thiab cov hlau hauv lub hlwb lossis cov khoom cog.

Leej twg yuav tsum xav txog qhov kev xeem no

Kev kuaj mob uas ua rau muaj peev xwm tshwm sim tsis yog kev kuaj mob dav dav. Nws yog qhov yuav tsum tau ua thaum tus kws kho mob xav tau cov pov thawj tseeb txog ib txoj kev tshwj xeeb. Cov xwm txheej ib txwm muaj xws li:

• Kab mob demyelinating uas xav tias muaj los yog paub tias muaj: VEP tuaj yeem muab pov thawj tseeb ntawm kev koom tes ntawm cov hlab ntsha optic yav dhau los thaum keeb kwm tsis paub meej.
• Kev poob qhov muag uas tsis paub meej: tshwj xeeb tshaj yog thaum qhov kev kuaj qhov muag zoo li qub, lossis thaum xav txog qhov kev poob qhov muag uas tsis yog organic.
• Cov menyuam mos thiab cov menyuam yaus: BERA qhov twg kev kuaj hnov ​​​​​​lus tsis tuaj yeem ua tau, suav nrog kev soj ntsuam kev hnov ​​​​​​lus thoob ntiaj teb rau cov menyuam mos.
• Xav tias yuav muaj kev hnov ​​​​​​lus tsis zoo retrocochlear: kev hnov ​​​​​​lus tsis sib xws lossis tinnitus, nrog rau kev kuaj mob audiometry thiab kev thaij duab.
• Mob qog nqaij hlav: SSEP qhov twg kev ua haujlwm ntawm txoj kev hnov ​​​​​​lus ntawm tus txha caj qaum xav tau kev ntsuam xyuas lub hom phiaj, piv txwv li hauv cervical spondylotic myelopathy lossis subacute combined degeneration los ntawm kev tsis txaus vitamin B12.
• Kev soj ntsuam thaum lub sijhawm phais: SSEP thiab MEP thaum lub sijhawm kho scoliosis, phais mob qog ntawm tus txha nqaj qaum, cov txheej txheem aortic thiab qee qhov kev phais hlwb.
• Kev kwv yees tom qab lub plawv nres lossis raug mob hlwb hnyav: SSEP siv rau hauv kev saib xyuas mob hnyav ua ib qho ntawm kev ntsuam xyuas ntau hom, tsis yog ib leeg xwb.

Qhov kev sim uas muaj peev xwm tshwm sim tsis tuaj yeem ntes tau lossis tshem tawm

• Nws tsis ua duab rau lub hlwb lossis tus txha caj qaum. Tej yam uas ua rau muaj tej yam tsis tuaj yeem qhia tau tias muaj qog nqaij hlav, los ntshav, lub disc prolapse lossis cov plaque uas ua rau cov leeg nqaij tsis muaj zog (demyelinating plaque). Yuav tsum tau thaij duab rau qhov ntawd.
• Nws tsis kuaj pom tias muaj ntau yam kab mob sclerosis. Cov peev xwm uas tshwm sim tsis yog ib feem ntawm cov qauv kuaj mob MS ib yam li MRI thiab cov kua dej hauv lub hlwb. VEP ib txwm tsis suav nrog MS, thiab VEP txawv txav tsis yog tshwj xeeb rau MS.
• Nws tsis tuaj yeem piav qhia meej meej. Tus VEP qeeb qhia rau koj tias txoj kev pom kev qeeb qee qhov chaw; nws tsis tuaj yeem hais meej qhov twg, lossis yog vim li cas.
• Nws tsis tuaj yeem cais cov ua rau muaj qhov no. Kab mob optic neuritis, glaucoma, compressive optic neuropathy, nutritional thiab toxic optic neuropathy thiab severe refractive error txhua yam tuaj yeem hloov VEP.
• BERA tsis yog kev ntsuam xyuas kev hnov ​​lus tag nrho. BERA kwv yees qhov txwv rau cov kev nyem, uas feem ntau yog qhia txog cov zaus siab dua. BERA tuaj yeem plam qhov poob qis qis thiab tsis ntsuas seb tus menyuam nkag siab li cas txog kev hais lus. Nws tsis suav nrog kev puas siab puas ntsws auditory neuropathy spectrum yam tsis muaj kev kuaj ntxiv.
• SSEP tsuas yog kuaj cov hlab ntsha loj xwb. Kab mob me me hu ua small-fibre neuropathy, tus qauv kub hnyiab uas pom muaj ntau hauv cov ntshav qab zib, tuaj yeem tshwm sim nrog SSEP ib txwm muaj.
• Nws tsis hais dab tsi txog qhov mob, kev nco lossis kev paub. Cov peev xwm uas tus qauv tsim tsis yog kev sim ntawm kev txawj ntse, kev puas hlwb lossis kev mob hlwb. Cov lus thov tias cov peev xwm uas tus qauv tsim ib txwm kuaj mob Alzheimer's lossis Parkinson's tsis raug txhawb nqa; cov peev xwm cuam tshuam nrog kev paub yog cov cuab yeej tshawb fawb, tsis yog kev kuaj mob hauv tsev kho mob.
• Qhov tshwm sim ib txwm tsis yog daim ntawv pov thawj tshem tawm. Ib qho peev xwm ua rau muaj zog ib txwm txhais tau tias tsis muaj qhov tsis zoo ntawm kev coj hluav taws xob tau pom hauv txoj kev ntawd rau hnub ntawd. Yog tias cov tsos mob tseem txuas ntxiv lossis hnyav zuj zus txawm tias qhov tshwm sim zoo li qub, rov qab mus rau koj tus kws kho mob.

Kev ntsuam xyuas sib txuas tab sis sib txawv

Cov kev ntsuam xyuas no teb cov lus nug sib txawv. Qhov twg ua ua ntej yog nyob ntawm qhov kev nthuav qhia: qhov mob poob qhov muag tam sim ntawd feem ntau mus rau kev ntsuam xyuas qhov muag thiab MRI; kev tshuaj ntsuam pob ntseg tsis zoo rau cov menyuam mos mus rau OAE thiab BERA; ko taw tingling hauv cov ntshav qab zib ntev mus rau kev tshawb fawb txog kev coj ntawm cov hlab ntsha, tsis yog SSEP.

Yuav npaj li cas

Kev npaj yog ib qho teeb meem ua haujlwm thiab txawv ntawm cov tsev kho mob thiab cov chav neurophysiology. Cov lus qhia sau rau koj tau txais yuav tseem ceeb dua li cov lus qhia dav dav, suav nrog nplooj ntawv no.

• Cov plaub hau thiab tawv taub hau: feem ntau cov chav tsev thov kom cov plaub hau huv si thiab tsis muaj roj, gel, wax lossis tshuaj tsuag plaub hau, vim tias cov no tiv thaiv kev sib cuag zoo ntawm electrode.
• Khoom noj khoom haus: Feem ntau tsis tas yuav yoo mov rau kev kuaj mob uas tus neeg mob tau hais. Noj zaub mov li qub tsuas yog tias koj lub chaw kho mob hais lwm yam xwb.
• Cov tshuaj kho mob: coj ib daim ntawv teev cov tshuaj uas koj siv tam sim no los. Cov tshuaj loog, cov tshuaj tiv thaiv kev qaug dab peg, cov tshuaj so cov leeg thiab qee cov tshuaj loog tuaj yeem hloov cov duab nthwv dej. Tsis txhob tsum lossis hloov cov tshuaj uas koj tau sau tseg rau koj tus kheej: nug tus kws sau ntawv lossis chav kho mob ua ntej.
• Cov tsom iav thiab cov iav sib txuas lus: rau VEP, coj koj cov tsom iav lossis cov iav lo ntsiab muag tam sim no thiab hnav lawv raws li cov lus qhia. Qhov yuam kev refractive tsis kho tuaj yeem ua rau qeeb thiab tsis muaj zog teb VEP.
• Hnov Aids: rau BERA, qhia rau tus kws kho txog cov khoom siv pab hnov ​​lus, grommets, cov kua tawm ntawm pob ntseg lossis cov quav ciab; cov quav ciab loj yuav tsum tau ntxuav ua ntej.
• Stimulants: qee chav tsev thov kom txwv tsis pub haus kas fes (caffeine) thaum nruab hnub. Tsis tas yuav txwv tsis pub haus kas fes thiab cawv li 24 teev.
• So thiab xis nyob: Kev so kom txaus pab tau, vim tias cov leeg nqaij nruj thiab ntsais muag ua rau muaj teeb meem. Hnav khaub ncaws xoob thiab xis nyob.

Cev xeeb tub

VEP, BAEP thiab SSEP tsis muaj kev siv hluav taws xob thiab tsis muaj kev sib piv. MEP nrog kev siv hlau nplaum transcranial feem ntau tsis raug tso tseg lossis ncua sijhawm thaum cev xeeb tub tshwj tsis yog tias muaj laj thawj kho mob muaj zog. Qhia rau lub chaw kuaj mob yog tias koj cev xeeb tub lossis tej zaum yuav cev xeeb tub.

Cov me nyuam thiab me nyuam mos

BERA rau cov menyuam mos feem ntau ua thaum lub sijhawm pw tsaug zog ntuj tom qab pub mis, lossis nyob rau hauv kev siv tshuaj loog lossis tshuaj loog dav dav rau cov menyuam laus uas tsis koom tes. Kev siv tshuaj loog muaj nws cov kev pheej hmoo thiab xav tau kev tso cai sib cais thiab cov lus qhia yoo mov los ntawm pab pawg neeg uas siv tshuaj loog. Ua raws li cov sijhawm yoo mov ntawd kom meej.

Kab mob qaug dab peg thiab photosensitivity

Cov neeg feem coob uas muaj mob qaug dab peg feem ntau zam tau tus kab mob VEP uas hloov pauv tus qauv. Qhia rau cov neeg ua haujlwm yog tias koj muaj mob qaug dab peg uas rhiab rau lub teeb. MEP los ntawm kev siv hlau nplaum yuav tsum tau kuaj xyuas tshwj xeeb rau cov neeg mob qaug dab peg.

Cov khoom siv cog thiab cov khoom siv

Cov khoom cog rau hauv lub hlwb (cochlear implants), cov khoom siv pab lub hlwb tob (deb brain stimulators), cov khoom siv pab lub plawv dhia (cardiac pacemakers) thiab cov khoom siv pab lub plawv dhia (defibrillators), thiab cov khoom siv clips lossis coils uas siv rau hauv lub hlwb (intracranial clips) yuav tsum tau muaj kev ntsuam xyuas kev nyab xeeb ua ntej siv magnetic-stimulation MEP. Cov kev ntsuam xyuas cov ntaub ntawv ntawm lub taub hau (scalp-electrode recording) tsis raug cuam tshuam tib yam nkaus.

Mob ntshav qab zib thaum kho mob glucose-lowering, CKD, mob plawv tsis ua haujlwm

Vim tias cov kev kuaj no feem ntau tsis tas yuav yoo mov lossis ntxiv dej rau hauv lub cev, cov kev pheej hmoo ib txwm tsis siv. Yog tias muaj kev npaj tshuaj loog rau ib tug menyuam yaus lossis ib tug neeg laus, qhia rau pab neeg txog insulin lossis lwm yam tshuaj uas txo cov piam thaj, cov sijhawm ntxuav ntshav, kev txwv cov dej lossis lub plawv tsis ua haujlwm, kom cov lus qhia txog kev yoo mov thiab cov dej tuaj yeem hloov kho tau.

Muaj dab tsi tshwm sim thaum lub sijhawm xeem

Ib tug kws kho tshuab ntsuas lub taub hau, cim qhov chaw ntawm lub electrode thiab muab cov tshuaj nplaum uas ua rau hluav taws xob ua haujlwm tau zoo; cov electrodes yog cov discs me me uas muaj cov tshuaj nplaum lossis lub hau. Lub taub hau yuav raug txhuam me ntsis kom txhim kho kev sib cuag, uas tuaj yeem ua rau khaus.

• VEP: koj zaum ntsia lub vijtsam thiab ntsia ib lub cim nruab nrab thaum tus qauv checkerboard tig rov qab. Txhua lub qhov muag raug kuaj cais. Kev tsom ntsoov ruaj khov tseem ceeb dua lwm yam.
• BERA: Lub mloog pob ntseg ua rau muaj suab nrov ntau zaus thaum koj pw twj ywm nrog ob lub qhov muag kaw; ntau tus neeg laus pw tsaug zog, uas yog qhov zoo.
• SSEP: lub zog hluav taws xob luv luv ntawm lub dab teg lossis pob luj taws ua rau muaj qhov kov lossis co, rov ua ntau zaus. Qhov hnyav tsuas yog teeb tsa kom txaus los ua rau cov leeg nqaij co me me.
• MEP: Ib lub kauj uas muab tso rau saum taub hau ua rau lub plawv dhia uas ua rau muaj lub suab nias thiab ib qho kev txav tes lossis ceg luv luv uas tsis tuaj yeem ua. Ib txhia neeg pom qhov no ua rau xav tsis thoob; mob taub hau lossis mob taub hau luv luv tuaj yeem tshwm sim.

Qhov kev xeem yuav siv sijhawm ntev npaum li cas

Feem ntau kev teeb tsa electrode yuav siv sijhawm li 10-20 feeb. Kev kaw ib qho modality ces siv sijhawm li 20-40 feeb, yog li kev teem sijhawm ib qho modality feem ntau siv sijhawm tag nrho 30-60 feeb. Kev tshawb fawb ua ke VEP, BAEP thiab SSEP feem ntau siv sijhawm 1.5-2 teev. Kev siv tshuaj loog rau menyuam yaus BERA siv sijhawm ntev dua vim tias lub sijhawm nyob twj ywm thiab rov zoo. Kev koom tes tsis zoo, kev ua tsis zoo, kev qaug zog thaum lub sijhawm VEP thiab qhov xav tau rov ua dua txhua yam ua rau lub sijhawm teem sijhawm ntev dua. Nug koj lub chaw rau nws lub sijhawm teem sijhawm thiab lub sijhawm tshaj tawm.

Kev nkag siab txog koj daim ntawv qhia

Daim ntawv tshaj tawm yuav piav qhia txog cov waveform peaks los ntawm lub npe thiab muab latency hauv milliseconds, amplitude hauv microvolts, thiab kev sib piv ntawm ob sab. Cov ntawv cim feem ntau suav nrog P100 rau VEP, nthwv dej I, III thiab V nrog IV interpeak interval rau BAEP, thiab N20 lossis P37 rau SSEP.

Cov nqi siv rau kev siv yog nyob rau hauv chav kuaj mob xwb . Txhua chav kawm txog lub paj hlwb tsim nws cov kev txwv ib txwm muaj raws li nws cov khoom siv, qhov chaw teeb tsa kev txhawb zog thiab cov pej xeem hauv zos, thiab cov no sib txawv raws li hnub nyoog. Vim li no tus lej latency los ntawm ib chav kuaj mob yuav tsum tsis txhob raug txiav txim siab piv rau lwm chav kuaj mob qhov kev txiav tawm, thiab tsis muaj lub rooj lej thoob ntiaj teb tuaj yeem hais tau raws li lub luag haujlwm.

• Lub sijhawm ntev ntev nrog cov duab waveform khaws cia: feem ntau taw qhia rau qhov demyelination ntawm txoj kev ntawd.
• Txo qhov loj me nrog qhov latency zoo li qub: ntau dua qhov qhia txog kev poob axonal lossis kev thaiv conduction.
• Qhov sib txawv ntawm ib sab mus rau ib sab: qhov tsis sib xws tuaj yeem muaj lub ntsiab lus txawm tias ob sab poob rau hauv qhov ntau ntawm chav kuaj.
• Tsis muaj lus teb: tej zaum yuav qhia txog kev ua haujlwm tsis zoo ntawm txoj kev, tab sis kuj tuaj yeem yog los ntawm kev ua tsis tiav ntawm kev siv tshuab, kev koom tes tsis zoo lossis kev hnov ​​​​lus lossis pom kev tsis zoo.

Daim ntawv qhia tsis yog kev kuaj mob. Tus kws kho mob hlwb uas tau thov kom kuaj ntawd yuav txhais nws raws li koj cov tsos mob, kev kuaj mob thiab kev thaij duab. Cov txiaj ntsig sib txawv nyob ntawm tus neeg mob tus mob.

Thaum cov txiaj ntsig tuaj yeem ua rau neeg nkag siab yuam kev

Tsis zoo li qub: latency zoo li ntev dua lossis amplitude me dua li qhov xwm txheej tiag tiag ntawm txoj kev

• Qhov yuam kev refractive tsis kho, cataract, qhov muag qhuav lossis lub qhov muag me me tuaj yeem ua rau VEP ntev thiab tsis ua haujlwm, zoo li kab mob ntawm cov hlab ntsha pom.
• Kev tsaug zog tsis zoo, kev kho tsis zoo lossis kev ntsais muag thaum lub sijhawm VEP ua rau cov lus teb poob qis.
• Cov quav ciab, cov kua dej hauv pob ntseg nruab nrab, lub qhov ntswg uas tawg lossis qhov hnov ​​​​​​lus tsis zoo uas twb muaj lawm qeeb cov nthwv dej BAEP thiab tuaj yeem yuam kev rau cov hlab ntsha lossis teeb meem ntawm lub hlwb.
• Cov ceg txias thiab qhov kub ntawm lub cev qis kev coj qeeb qeeb thiab ua kom ntev SSEP latencies.
• Siab los yog ceg ntev ua kom qhov kev ncua deb mus ntev dua, yog li ntawd cov latencies tag nrho ntev dua rau cov tib neeg ib txwm.
• Cov tshuaj loog, cov tshuaj loog thiab qee cov tshuaj anticonvulsants txo cov lus teb cortical, tshwj xeeb tshaj yog MEP.
• Kev sib koom ua ke ntawm peripheral neuropathy: feem ntau nyob rau hauv Is Nrias teb nrog ntshav qab zib, vitamin B12 tsis txaus thiab haus dej cawv, qeeb SSEP ntawm theem peripheral thiab tuaj yeem nyeem tsis raug raws li kab mob hauv nruab nrab.
• Kev nruj ntawm cov leeg nqaij, kev tshee hnyo, kev cuam tshuam hluav taws xob thiab xov tooj ntawm tes tsim cov khoom siv uas ua raws li qhov tsis zoo.

Dag li qub los yog dag kom ntseeg siab

• Cov qhov txhab me me los yog ib nrab tej zaum yuav tsis qeeb qeeb txaus kom poob sab nraum cov kev txwv hauv chav kuaj.
• Kev puas tsuaj tsis ntev los no tej zaum yuav tseem tsis tau qhia txog cov kev hloov pauv uas xav tau; kev rov zoo ntawm latency kuj tuaj yeem tshwm sim ntau lub hlis tom qab optic neuritis, yog li VEP ib txwm tsis tau txhais hais tias qhov xwm txheej yeej tsis tau tshwm sim.
• Cov qhov txhab sab nraum txoj kev sim yuav tsis tshwm sim li, qhov mob ntawm lub hauv paus tsis hloov VEP.
• Kev koom tes me me thiab kev koom tes ntawm tus kheej tsis pom rau SSEP.
• BERA tuaj yeem ze li qub hauv kev hnov ​​​​​​lus me me lossis qis zaus, thiab nyob rau hauv cov teeb meem kev ua haujlwm hnov.

Kev Pheej Hmoo thiab Kev Nyab Xeeb

Cov kev tshawb fawb sib txawv muaj cov qauv kev pheej hmoo sib txawv, yog li ib daim ntawv qhia txog kev nyab xeeb tsis siv rau txhua tus.

VEP thiab BAEP

Cov no suav nrog kev kaw cov electrodes ntxiv rau lub teeb lossis suab. Kev pheej hmoo tsawg heev: mob taub hau me ntsis los ntawm cov nplaum lossis kev sib txhuam, mob qhov muag ib ntus, mob taub hau, thiab tsis tshua muaj kev qaug dab peg hauv ib tus neeg uas muaj tus kab mob qaug dab peg uas rhiab heev rau lub teeb.

SSEP

Cov hluav taws xob pulses luv luv thiab tsis muaj zog tab sis tuaj yeem ua rau tsis xis nyob, tshwj xeeb tshaj yog ntawm pob luj taws. Ib ntus tingling, me ntsis kev tsis haum ntawm daim tawv nqaij ntawm qhov chaw txhawb nqa thiab cov leeg nqaij co.

MEP

Kev siv hlau nplaum ua kom lub taub hau tsis xis nyob, mob taub hau ib ntus, mob caj dab thiab ntswj ntsej muag. Kev ua kom qaug dab peg tsis tshua muaj tab sis paub tseeb, yog li yuav tsum tau kuaj xyuas seb puas muaj feem yuav qaug dab peg thiab nrhiav cov khoom siv cog rau hauv lub cev ua ntej.

Kev soj ntsuam thaum lub sijhawm phais thiab koob electrodes

Thaum siv cov koob electrodes, muaj kev pheej hmoo me ntsis ntawm kev los ntshav hauv zos, kev mob nqaij lossis kev kis kab mob ntawm qhov chaw ntxig. MEP thaum lub sijhawm phais tuaj yeem ua rau tus nplaig lossis daim di ncauj raug mob los ntawm cov leeg nqaij ntawm lub puab tsaig, uas cov pab pawg ua yeeb yam tiv thaiv nrog kev thaiv tom.

Kev siv tshuaj loog rau menyuam yaus

Qhov twg siv tshuaj loog lossis tshuaj loog rau BERA rau menyuam yaus, cov kev pheej hmoo tseem ceeb yog kev siv tshuaj loog nws tus kheej, kev nyuaj siab ua pa, teeb meem ua pa thiab qaug zog ntev, thiab raug tswj hwm los ntawm pab pawg tshuaj loog.

Cov xwm txheej tshwj xeeb

Cev xeeb tub

Kev siv cov peev xwm evoked raws li kev kaw cia yog ua thaum cev xeeb tub thaum xav tau kev kho mob, vim tias tsis muaj kev siv hluav taws xob lossis kev sib piv. Kev siv hlau nplaum MEP feem ntau raug ncua. Kev pw tiaj tiaj ntev thaum kawg ntawm cev xeeb tub tuaj yeem ua rau tsis xis nyob; kev pw ntawm sab laug pab tau.

Cov menyuam mos thiab cov menyuam yaus

BERA yog qhov tseem ceeb rau kev ntsuam xyuas kev hnov ​​​​lus ntawm cov menyuam mos hauv Is Nrias teb, qhov twg kev tshuaj xyuas kev hnov ​​​​lus ntawm cov menyuam mos thoob ntiaj teb tab tom nthuav dav raws li National Program for Prevention and Control of Lag Ntseg. Cov nqi ib txwm txawv ntawm cov neeg laus vim tias myelination tsis tiav; cov qauv kuaj mob hauv chaw kuaj mob menyuam yaus yuav tsum tau siv. Kev txheeb xyuas thaum ntxov tseem ceeb vim nws ua rau kev txiav txim siab txog cov khoom siv pab hnov ​​​​lus thiab cochlear implantation.

Cov laus

Cov sijhawm qeeb qeeb ntev zuj zus thiab qhov loj me poob qis me ntsis nrog rau hnub nyoog. Cov qauv kuaj mob uas sib xws nrog hnub nyoog yog qhov tseem ceeb, lossis kev laus ib txwm yuav raug tshaj tawm tias yog kab mob. Cov kab mob cataract, presbyacusis thiab spondylosis uas muaj nyob ua ke yog cov teeb meem uas tshwm sim ntau.

Mob ntshav qab zib

Kab mob ntshav qab zib uas kav ntev feem ntau cuam tshuam rau cov hlab ntsha peripheral, uas hloov SSEP ntawm qhov peripheral segment. Kev txhais lus yuav tsum piav qhia txog qhov no ua ntej xaus lus tias muaj kev koom tes ntawm cov hlab ntsha qaum lossis lub hlwb.

CKD thiab lub plawv tsis ua haujlwm

Kab mob Uraemic neuropathy tuaj yeem ua rau cov hlab ntsha hauv lub plawv qeeb. Cov neeg uas muaj teeb meem plawv tsis ua haujlwm yuav pom tias qhov chaw pw ntev ntev nyuaj; qhia rau tus kws kho mob kom hloov kho qhov chaw.

Kev saib xyuas mob hnyav thiab coma

SSEP siv rau hauv kev kwv yees tom qab lub plawv nres thiab raug mob hlwb hnyav, tab sis tsuas yog ib qho khoom ua ke nrog kev kuaj mob hauv chaw kho mob, EEG, kev thaij duab thiab cov cim qhia txog cov kab mob, thiab tsuas yog tom qab kev siv tshuaj loog, hypothermia thiab kev cuam tshuam ntawm lub cev tau raug suav hais tias muaj. Tsis muaj ib qho tshwm sim uas yuav tsum tsav tsheb txiav txim siab txog kev rho tawm ntawm kev kho mob.

Ua rau muaj kev sim siab hauv Is Nrias teb

• muaj: Cov chaw kuaj mob uas muaj peev xwm tshwm sim tau muab tso rau hauv cov tsev kawm qib siab kho mob, cov tsev kho mob theem peb thiab cov chaw kuaj mob ntiag tug loj dua. BERA yog hom kev siv dav tshaj plaws vim nws siv rau hauv kev kho mob menyuam yaus.
• Vitamin B12 tsis muaj peev xwm yog ib qho uas tshwm sim ntau, tshwj xeeb tshaj yog nrog cov neeg tsis noj nqaij, thiab kev puas tsuaj ua ke subacute tuaj yeem ua rau muaj SSEP tsis zoo nrog rau qhov ua rau kho tau. Kev kuaj xyuas B12 feem ntau muaj txiaj ntsig zoo dua li kev rov ua dua neurophysiology.
• Kab mob ntsws thiab nws txoj kev kho mob: ethambutol tuaj yeem ua rau mob hlwb ntawm qhov muag thiab isoniazid tuaj yeem ua rau mob hlwb ntawm sab nraud. Yog tias koj tab tom noj tshuaj tiv thaiv kab mob ntsws thiab pom kev tsaus ntuj, xim tsis zoo lossis loog, hu rau koj tus kws kho mob sai sai, tsis txhob tsum noj tshuaj koj tus kheej.
• Kev noj haus thiab tshuaj lom optic neuropathy los ntawm cawv, luam yeeb thiab kev noj zaub mov tsis zoo yog qhov ua rau muaj VEP tsis zoo.
• Tsis hnov ​​lus: mob pob ntseg mob ntev thiab mob pob ntseg nruab nrab yog qhov tshwm sim thiab tsim cov kev hloov pauv uas yuav tsum tau cais tawm ntawm qhov tsis zoo ntawm txoj hlab ntsha ua ntej BERA raug txhais.
• Multiple sclerosis thiab neuromyelitis optica spectrum disorder: NMOSD feem ntau tshwm sim hauv cov pej xeem Isdias thiab lwm cov neeg Esxias dua li cov neeg nyob sab hnub poob, thiab feem ntau muaj mob optic neuritis hnyav. Kev paub qhov txawv ntawm nws yuav tsum tau kuaj cov tshuaj tiv thaiv kab mob thiab MRI, tsis yog kuaj cov peev xwm tshwm sim.
• Lub npe: Cov kev thov yuav nyeem tau tias "EP studies", "VEP both eyes", "BERA", "SSEP upper and lower limbs", lossis "multimodality evoked potentials". Paub meej tias hom kev kho mob twg tau xaj thaum koj teem caij, vim tias lub sijhawm teem caij thiab tus nqi nyob ntawm nws.
• Cov ntaub ntawv tiv thaiv: Cov kab ke thiab cov ntawv qhia txog kev noj qab haus huv ntawm lub paj hlwb yog cov ntaub ntawv kev noj qab haus huv ntawm tus kheej. Raws li Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital 2023, nug seb koj cov ntaub ntawv thiab txhua lub portal tshaj tawm online raug tswj hwm thiab sib qhia li cas.

Tus nqi thiab kev pov hwm hauv Is Nrias teb

Cov nqi sib txawv ntawm cov tsev kho mob tsoomfwv, cov tsev kho mob trust thiab cov chaw kho mob ntiag tug, thiab ntawm cov nroog. Cov nqi feem ntau raug hais txog ib hom kev kho mob, yog li kev tshawb fawb ntau hom kev kho mob raug nqi ntau zaus rau ib tus VEP.

Cov yam uas cuam tshuam rau tus nqi:

• Tus naj npawb ntawm cov qauv thov, VEP ib leeg piv rau VEP ntxiv rau BAEP ntxiv rau SSEP
• Ob sab piv rau ib sab kev kaw suab, thiab sab saud ntxiv rau sab qis SSEP
• Kev siv tshuaj loog los yog tshuaj loog rau cov menyuam mos thiab cov menyuam tsis koom tes, uas ntxiv cov nqi rau tus kws kho mob loog thiab saib xyuas
• Kev soj ntsuam neurotransmission thaum lub sijhawm phais, uas raug them nqi los ntawm lub sijhawm thiab cov neeg ua haujlwm thiab kim dua li kev tshawb fawb sab nraud
• Tus neeg mob pw hauv tsev kho mob piv rau tus neeg mob sab nraud chaw, thiab kev kuaj mob ntawm txaj ICU
• Qib nroog, pawg tsev kho mob thiab kev lees paub
• Cov pob khoom sib xyaw ua ke kev sib txuas ua ke EEG, kev tshawb fawb txog kev coj ua ntawm cov hlab ntsha thiab cov peev xwm ua rau muaj

Txog kev pov hwm: kev kuaj mob sab nraud feem ntau tsis them los ntawm cov cai tswjfwm kev noj qab haus huv tus qauv tshwj tsis yog tias muaj tus neeg caij OPD. Thaum kev kuaj mob yog ib feem ntawm kev nkag mus lossis kev phais mob nrog kev saib xyuas thaum phais mob, nws feem ntau yuav tsum tau them, raws li koj cov nqe lus ntawm txoj cai, lub sijhawm tos thiab kev tso cai ua ntej. Cov phiaj xwm tsoomfwv suav nrog Ayushman Bharat PM-JAY them cov txheej txheem raws li lawv tus kheej cov nqi pob ntawm cov tsev kho mob empaneled. Paub meej tias kev them nqi thiab tau txais kev kwv yees sau ua ntej lub sijhawm teem tseg.

Cov lus dab neeg thiab qhov tseeb

Lus nug cov lus nug

Qhov kev sim uas muaj peev xwm ua rau mob puas yog?

VEP thiab BERA tsis mob. SSEP muaj cov hluav taws xob me me uas rov ua dua uas zoo li kov lossis co thiab tuaj yeem ua rau tsis xis nyob me ntsis. MEP ua rau muaj lub suab nrov thiab kev txav mus los luv luv, nrog rau qhov mob taub hau. Qhia rau tus kws kho mob yog tias muaj kev txhawb nqa nyuaj rau thev taus, vim tias qhov hnyav feem ntau tuaj yeem hloov kho.

Kuv puas yuav tsum tau yoo mov ua ntej qhov kev kuaj mob uas yuav tshwm sim?

Feem ntau tsis tas yuav yoo mov rau kev sau cov ntaub ntawv uas ua rau muaj kev ntxhov siab. Noj thiab noj koj cov tshuaj ib txwm tsuas yog koj lub chaw kho mob qhia lwm yam. Yog tias npaj yuav siv tshuaj loog lossis tshuaj loog, feem ntau yog rau tus menyuam mos uas tab tom siv BERA, pab neeg uas siv tshuaj loog yuav muab sijhawm yoo mov tshwj xeeb uas yuav tsum tau ua raws li.

Puas muaj peev xwm kuaj tau tus kab mob multiple sclerosis ntawm nws tus kheej?

Tsis yog. Tej yam uas ua rau muaj peev xwm ua rau muaj peev xwm muab pov thawj txhawb nqa tias txoj kev xws li cov hlab ntsha pom kev raug cuam tshuam, uas yuav pab tau thaum keeb kwm tsis meej. Kev kuaj mob ntawm ntau yam kab mob sclerosis nyob ntawm kev ntsuam xyuas kev kho mob, MRI ntawm lub hlwb thiab tus txha caj qaum, thiab qee zaum kuaj cov kua dej hauv lub hlwb.

Qhov txawv ntawm kev sim ua kom muaj peev xwm thiab kev kawm txog kev coj mus los ntawm cov hlab ntsha yog dab tsi?

Kev tshawb nrhiav txog kev xa xov ntawm cov hlab ntsha ntsuas cov hlab ntsha thiab cov leeg nqaij ncaj qha thiab yog qhov kev xaiv ib txwm muaj rau kev xav tias muaj mob neuropathy lossis cov hlab ntsha raug ntes. Cov peev xwm uas tshwm sim ua raws li txoj kev ntev dua mus rau hauv cov hlab ntsha caj qaum thiab lub hlwb, uas yog qhov muaj txiaj ntsig thaum muaj kev koom tes hauv nruab nrab yog lo lus nug. Cov kev xeem teb cov lus nug sib txawv thiab qee zaum ua ke.

Vim li cas kuv daim ntawv qhia tsis piv kuv cov lej nrog tus qauv?

Cov kev txwv ib txwm rau cov peev xwm tshwm sim yog tshwj xeeb rau txhua lub chaw kuaj mob cov khoom siv, cov kev ntsuas kev txhawb nqa thiab cov pej xeem siv, thiab lawv hloov pauv nrog hnub nyoog thiab qhov siab. Tus kws kho mob hlwb piv koj cov nqi nrog cov ntaub ntawv hnub nyoog sib phim ntawm lub chaw kuaj mob ntawd, yog vim li cas lub rooj txheem sab nraud tsis tuaj yeem siv rau koj cov kab.

Kuv qhov kev kuaj mob zoo li qub tab sis kuv cov tsos mob tseem muaj. Yuav ua li cas tam sim no?

Qhov tshwm sim ib txwm txhais tau tias tsis muaj qhov tsis zoo ntawm kev coj hluav taws xob hauv txoj kev kuaj hnub ntawd. Nws tsis tau txhais hais tias tsis muaj dab tsi tsis ncaj ncees lawm. Rov qab mus rau tus kws kho mob uas tau thov kom kuaj; kev thaij duab ntxiv, kev kuaj ntshav lossis kev ntsuam xyuas ntawm txoj kev sib txawv tej zaum yuav tsim nyog.

Kuv tus menyuam puas siv tau BERA yam tsis muaj tshuaj loog?

Feem ntau yog. Cov menyuam mos feem ntau raug kuaj thaum lub sijhawm pw tsaug zog ntuj tom qab pub mis, uas ntau lub chaw kuaj mob nyiam. Cov menyuam mos thiab cov menyuam yaus uas loj dua uas tsis tuaj yeem nyob twj ywm yuav xav tau kev tsaug zog lossis kev siv tshuaj loog luv luv, txiav txim siab nrog pab pawg tshuaj loog thiab nrog kev pom zoo sib cais thiab cov lus qhia yoo mov.

Kuv puas tsav tsheb mus tsev thiab rov qab mus ua haujlwm tom qab ntawd tau?

Tom qab kev tshawb fawb txog kev kho mob sab nraud, feem ntau cov neeg rov qab ua ub ua no li qub tam sim ntawd, suav nrog kev tsav tsheb. Cov tshuaj uas ua rau lub qhov muag qhib, kev siv tshuaj loog lossis mob taub hau tom qab MEP tuaj yeem hloov qhov ntawd. Txhua tus neeg uas tau siv tshuaj loog yuav tsum npaj ib tus neeg nrog thiab yuav tsum tsis txhob tsav tsheb hnub ntawd.

Cov roj plaub hau lossis cov tshuaj zas plaub hau puas yuav cuam tshuam rau qhov kev kuaj?

Cov roj, gel thiab cov quav ciab cuam tshuam rau kev sib cuag ntawm electrode thiab tuaj yeem ua rau cov ntaubntawv povthawj tsis zoo, yog li feem ntau cov khoom xav tau cov plaub hau huv, qhuav, tsis muaj tshuaj. Cov xim pleev plaub hau nws tus kheej feem ntau tsis yog teeb meem. Cov plaub hau tuab, sib xyaws nruj lossis cov plaub hau hnyav yuav tsum tau xoob kom cov electrodes tuaj yeem ncav cuag lub taub hau.

Qhov chaw

• Lub Koom Haum Thoob Ntiaj Teb ntawm Kev Kho Mob Neurophysiology, cov lus pom zoo thiab cov txheej txheem rau kev sau thiab tshaj tawm cov ntaub ntawv uas tau tshwm sim.
• American Clinical Neurophysiology Society, cov lus qhia txog kev pom, kev hnov ​​​​​​lus thiab somatosensory evoked potentials thiab ntawm kev saib xyuas neurophysiological intraoperative.
• British Society of Clinical Neurophysiology thiab British Society of Audiology, cov lus qhia txog kev xyaum ua haujlwm ntawm kev ntsuam xyuas kev teb ntawm lub hlwb pob ntseg.
• Lub Koom Haum Thoob Ntiaj Teb rau Kev Ua Haujlwm Neurophysiology, cov lus hais txog kev saib xyuas SSEP thiab MEP hauv kev ua haujlwm.
• Cov qauv McDonald rau kev kuaj mob ntawm ntau yam sclerosis, raws li tau luam tawm los ntawm International Panel on Diagnosis of Multiple Sclerosis.
• Kev Pab Cuam Hauv Tebchaws rau Kev Tiv Thaiv thiab Tswj Kev Lag Ntseg, Ministry of Health thiab Family Welfare, Tsoomfwv Is Nrias teb.
• Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023, Tsoomfwv Is Nrias teb.