Flachenecker P, Janka M, Goldbrunner R, Toyka K V
Department of Neurology, University of Würzburg, Germany.
J Neurol. 1999 Feb;246(2):93-6. doi: 10.1007/s004150050314.
Sural nerve biopsy is a valuable tool in establishing the diagnosis and investigating the underlying causes of peripheral neuropathies. Few investigations have been carried out in which the sequelae of this procedure have been described systematically. We studied the short-term adverse reactions in 110 patients and the long-term outcome of sural nerve biopsy in a subgroup of 54 patients after 5-32 months. Long-lasting sensory deficits were reported in 93%, dysaesthesia in 19% and mild persistent pain in 33% of the 54 patients. No significant differences were found between patients followed for 1-2 years and those followed for more than 2 years in the frequency and distribution of hypaesthesia and anaesthesia. However, dysaesthesia was less frequent after more than 2 years (6/32 vs 1/16), and persistent pain completely subsided within our observation period. We conclude that disabling sequelae regress and finally subside over time. If we assume that returning for follow-up visits may cause bias towards more severely affected patients, the overall prognosis may be even better.
腓肠神经活检是诊断周围神经病变及探究其潜在病因的一项重要手段。很少有研究系统地描述过该操作的后遗症。我们对110例患者的短期不良反应进行了研究,并对54例患者在5至32个月后的腓肠神经活检长期结果进行了研究。在这54例患者中,93%报告有持久的感觉缺失,19%有感觉异常,33%有轻度持续性疼痛。随访1至2年的患者与随访超过2年的患者在感觉减退和麻木的频率及分布方面未发现显著差异。然而,超过2年后感觉异常的发生率较低(6/32 vs 1/16),并且在我们的观察期内持续性疼痛完全消退。我们得出结论,致残性后遗症会随着时间推移而减轻并最终消退。如果我们认为复诊可能会使受影响更严重的患者出现偏差,那么总体预后可能会更好。