Mitsumoto H, Estes M L, Wilbourn A J, Culver J E
Department of Neurology, Cleveland Clinic Foundation, Ohio 44195.
Muscle Nerve. 1992 Dec;15(12):1364-8. doi: 10.1002/mus.880151212.
A 42-year-old man showed signs and symptoms suggestive of carpal-tunnel syndrome, but EMG showed an isolated motor axon-loss lesion affecting the right median nerve distally. After the MRI revealed a mass in the median nerve, surgical exploration showed a diffusely swollen median motor branch. Biopsy showed a lesion with marked onion-bulb formation composed of perineurial cells as identified by immunohistochemical analyses and electron microscopic examination. Although we previously coined the term "perineurioma" for this condition, re-reviews of our cases do not support the idea that the onion-bulb lesion is a benign tumor; instead, it appears to be reactive hyperplasia. Although rare, electromyographers and neurologists need to be aware of this problem because it is self-limited and does not require surgical resection.
一名42岁男性表现出腕管综合征的体征和症状，但肌电图显示为孤立的运动轴突丢失性病变，累及右侧正中神经远端。MRI显示正中神经有肿物，手术探查发现正中运动支弥漫性肿胀。活检显示病变有明显的葱皮样结构，由免疫组化分析和电子显微镜检查确定为神经束膜细胞。尽管我们之前将这种情况称为“神经束膜瘤”，但对我们病例的再次回顾并不支持葱皮样病变是良性肿瘤的观点；相反，它似乎是反应性增生。虽然罕见，但肌电图检查人员和神经科医生需要意识到这个问题，因为它是自限性的，不需要手术切除。
