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잠수 후 두통이 동반된 척수형 감압병 환자에서 후경골신경 감각유발전위의 예후 예측 효과

Posterior Tibial Somatosensory Evoked Potential as a Prognostic Factor in Spinal Cord Decompression Sickness with Headache

두통 2019년 20권 2호 p.17 ~ 21
이승현 ( Lee Seung-Hyun ) - 서울의료원 신경과

안진영 ( Ahn Jin-Young ) - 서울의료원 신경과

Abstract


Background: Headache can be as complicated as a symptom of spinal cord decompression sickness (DCS). Somatosensory evoked potentials are the electrical potentials generated in sensory pathways at peripheral, spinal, subcortical and cortical levels of the nervous system and are frequently used to evaluate myelopathy. This study
aims to determine utility of initial PTSEP (posterior tibial somatosensory evoked potential) as a prognostic factor associated with the development of severe diving-related spinal cord decompression sickness (DCS) with or without
headache.

Methods: 68 injured divers (with headache n=34, without headache n=34) presenting symptoms of spinal cord DCS were retrospectively included from Seoul Medical Center. Diving information, time interval between symptom onset, hyperbaric treatment and initial PTSEP were studied. The initial severity of spinal cord DCS was rated with the Boussuges severity score and muscle power examination and the presence of sequelae was evaluated at 2 weeks. The Tables used in the initial treatment for spinal cord DCS included US navy table6 or table6a.

Results: There were no significant differences between each treatment group in age, diving experience, depth of dive. bottom time of dive, onset to treatment, Boussuges’s score and the grade of motor power before the treatment. The motor power improvements were noticed in initial normal PTSEP group (57.1%) than abnoraml group (20%) with headache group. But the motor power improvements showed no differences between groups without headache.

Conclusion: The presence of initial abnormal PTSEP with headache might be useful poor prognostic factor in spinal cord DCS.

키워드

Spinal cord decompression sickness; Headache; Posterior tibial somatosensory evoked potential
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