PARAESTHESIAE FROM ECTOPIC IMPULSE GENERATION IN HUMAN SENSORY NERVES
PARAESTHESIAE FROM ECTOPIC IMPULSE GENERATION IN HUMAN SENSORY NERVES
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DOI：
10.1093/brain/103.4.835
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发表时间：
1980-01-01
期刊：
影响因子：
14.5
通讯作者：
TOREBJORK, HE
中科院分区：
文献类型：
--
作者：
OCHOA, JL;TOREBJORK, HE
神经内微电极记录获得清醒的正常受试者经历缺血后感觉异常的感觉神经束。传入纤维的自发活动在循环重建后约半分钟开始，在第二分钟达到峰值，此后缓慢减弱。这与感觉异常的时间进程和强度平行。在感觉异常的最强烈阶段，单个单位放电由持续1至7秒的长时间高频脉冲（200-300 imp/s）组成。随着感觉异常的减弱，重复的爆发逐渐变短，并经常表现出明显的节律性。过度换气增加阵发性放电和感觉异常，而缺血期重复在短时间内耗尽的冲动产生机制。局部麻醉阻滞的结果表明，冲动产生异位沿着的神经纤维以前受到缺血，而不是主要从皮肤中的受体。高频率的放电和各种感觉异常的质量和分布表明，有髓纤维的感觉单位参与了阵发性放电;正常活动，但无异位放电记录在无髓纤维。有人提出，变态质量的感觉异常是由于一个异常的时空格局异位脉冲从不同类型的感觉单位。创造出一种混乱的感觉，它由各种各样的感觉组成，这些感觉不规则地连续出现在多个区域。
Intraneural microelectrode recordings were obtained from sensory nerve fascicles in awake normal subjects experiencing post-ischaemic paraesthesiae. Spontaneous activity in afferent fibres started about half a minute after re-establishment of circulation; it peaked by the second minute and slowly waned thereafter. This parallelled the time course and intensity of the perceived paraesthesiae. During the most intense stage of paraesthesiae, single unit discharges consisted of prolonged bursts of high-frequency impulses (200-300 imp/s) lasting for 1 to 7 seconds. Repeated bursts became progressively shorter and often exhibited marked rhythmicity as paraesthesiae became weaker. Hyperventilation increased paroxysmal firing and paraesthesiae, whereas ischaemic periods repeated at short intervals exhausted the impulse generating mechanism. The outcome of local anaesthetic blocks indicated that the impulses were generated ectopically along the nerve fibres previously subjected to ischaemia and not primarily from the receptors in the skin. The high frequency of the discharge and the quality and distribution of various paraesthesiae suggest that sensory units with myelinated fibres participated in the paroxysmal discharge; normal activity, but no ectopic discharges were recorded in unmyelinated fibres. It is proposed that the perverted quality of paraesthesiae is due to an abnormal spatio-temporal pattern of ectopic impulses from different types of sensory units. creating a chaotic percept consisting of an assortment of sensations referred in irregular succession to multiple areas.