Seror P, Maisonobe T, Viala K, Bouche P
Laboratoire d'Electromyographie, Hôpital de la Salpêtriere, Paris.
Presse Med. 2005 Jul 2;34(12):856-8. doi: 10.1016/s0755-4982(05)84063-1.
Lumbosacral plexopathy is the equivalent in the lower limbs of neuralgic amyotrophy (also known as Parsonage-Turner syndrome) in the upper limbs. It is well-known in patients with diabetes mellitus, when it is known as Bruns-Garland syndrome.
We report the case of a 47-year-old woman who developed a unilateral neuropathy of the leg, neither radicular nor truncal in origin. The slow continuous improvement was not affected by any of the treatments administered.
Lumbosacral plexopathy is characterized by intense pain in one or both legs, associated with motor and sensory deficits. Recovery is usually slow (6 to 36 months) and often incomplete. The electrodiagnostic examination shows important acute motor and sensory axonal loss, characterized by denervation and low-amplitude sensory action potential. Treatment generally combines analgesics with narcotic agents, neuropathic pain medication, short-term corticosteroids, and rehabilitation. In the most severe cases, long-term corticosteroids and other immunosuppressive agents may be required. This diagnosis cannot be reached until all other radicular, plexal and truncal origins have been ruled out.
腰骶丛神经病相当于上肢的神经性肌萎缩(也称为帕森热-特纳综合征)在下肢的表现。在糖尿病患者中较为常见,此时被称为布伦斯-加兰综合征。
我们报告一例47岁女性病例,该患者出现单侧腿部神经病变,既非神经根性也非躯干性起源。病情缓慢持续改善,不受所给予的任何治疗影响。
腰骶丛神经病的特征是一条或两条腿剧痛,伴有运动和感觉功能缺损。恢复通常缓慢(6至36个月)且常不完全。电诊断检查显示重要的急性运动和感觉轴突丧失,其特征为失神经支配和低波幅感觉动作电位。治疗通常将镇痛药与麻醉剂、神经性疼痛药物、短期皮质类固醇及康复治疗相结合。在最严重的病例中,可能需要长期使用皮质类固醇和其他免疫抑制剂。在排除所有其他神经根性、丛性和躯干性起源之前,无法做出此诊断。