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早期急性炎症性脱髓鞘性多发性神经根神经病的神经生理学表现

Neurophysiologic findings in early acute inflammatory demyelinating polyradiculoneuropathy.

作者信息

Vucic Steve, Cairns Kevin D, Black Kristin R, Chong Peter Siao Tick, Cros Didier

机构信息

Department of Neurology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.

出版信息

Clin Neurophysiol. 2004 Oct;115(10):2329-35. doi: 10.1016/j.clinph.2004.05.009.

Abstract

BACKGROUND

Patients with early acute inflammatory demyelinating polyradiculoneuropathy (AIDP) may not meet the current neurophysiologic criteria.

OBJECTIVE

To document neurophysiologic findings in early AIDP.

METHODS

Clinical and neurophysiologic data from 38 AIDP patients, assessed within 10 days of symptom onset were reviewed.

RESULTS

In addition to absent H reflexes and abnormal F-wave responses in the acute stage of AIDP, abnormalities of blink reflexes, upper limb sensory responses abnormalities with spared sural responses, presence of distal CMAP dispersion, and A-waves were frequently observed. Established demyelinating neurophysiologic parameters were infrequently seen.

CONCLUSIONS

Abnormalities of H reflexes and F responses were most frequently noted in early AIDP. Additionally, distal temporal dispersion, prolonged or absent blink reflexes, and A-waves were often present in the acute stage of AIDP when classic diagnostic criteria of AIDP were not satisfied.

SIGNIFICANCE

Neurophysiologic studies in early AIDP frequently reveal abnormalities that are not specific of primary demyelinating neuropathy.

摘要

背景

早期急性炎性脱髓鞘性多发性神经根神经病(AIDP)患者可能不符合当前的神经生理学标准。

目的

记录早期AIDP的神经生理学表现。

方法

回顾了38例AIDP患者在症状出现10天内的临床和神经生理学数据。

结果

除了AIDP急性期H反射消失和F波反应异常外,还经常观察到瞬目反射异常、上肢感觉反应异常伴腓肠神经反应正常、远端复合肌肉动作电位(CMAP)离散以及A波。很少见到典型的脱髓鞘神经生理学参数。

结论

早期AIDP中最常出现H反射和F反应异常。此外,当AIDP的经典诊断标准不满足时,在AIDP急性期常出现远端时间离散、瞬目反射延长或消失以及A波。

意义

早期AIDP的神经生理学研究经常揭示出并非原发性脱髓鞘性神经病所特有的异常。

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