Schüller T B, Hermann K, Baron R
Klinik für Neurologie, Christian-Albrechts-Universität Kiel, Germany.
J Neurol. 2000 Apr;247(4):267-72. doi: 10.1007/s004150050582.
We compared three neurophysiological methods for assessing small nerve fiber function in 40 patients with peripheral neuropathy to determine the various manifestation types of peripheral small fiber neuropathy. Heart rate variation tests were used to assess cardiac parasympathetic small fiber function. Cutaneous vasoconstrictor responses (sympathetic C fibers) induced by deep inspiration were examined with laser Doppler flowmetry. Cutaneous afferent C fiber function was assessed by measurement of axon reflex vasodilatation induced by histamine iontophoresis. All test parameters were significantly lower in patients with peripheral neuropathy than in control subjects. Comparison of the three small fiber systems revealed that functionally different systems are damaged independently, and isolated affection of each fiber type was frequently observed. The three tests are useful noninvasive tools with which to evaluate sympathetic, parasympathetic, and afferent small fiber function in patients with peripheral neuropathy. In many patients functionally different small fiber systems are affected selectively. To diagnose small fiber neuropathy and to evaluate the individual type of manifestation complementary testing of several small somatic and autonomic fiber systems is necessary.
我们比较了三种神经生理学方法，以评估40例周围神经病患者的小神经纤维功能，从而确定周围小纤维神经病的各种表现类型。采用心率变异性测试来评估心脏副交感小纤维功能。用激光多普勒血流仪检测深吸气诱发的皮肤血管收缩反应（交感C纤维）。通过测量组胺离子透入诱发的轴突反射性血管扩张来评估皮肤传入C纤维功能。周围神经病患者的所有测试参数均显著低于对照组。对三种小纤维系统的比较显示，功能不同的系统会独立受损，且经常观察到每种纤维类型的单独受累。这三种测试是评估周围神经病患者交感、副交感和传入小纤维功能的有用的非侵入性工具。在许多患者中，功能不同的小纤维系统会被选择性地累及。为了诊断小纤维神经病并评估个体表现类型，有必要对几个躯体和自主小纤维系统进行补充测试。
