Maisonobe T
Fédération de Neurophysiologie Clinique et Laboratoire de Neuropathologie R. Escourolle, Hôpital de la Pitié-Salpêtrière, Paris.
Rev Neurol (Paris). 2006 Apr;162(4):527-32. doi: 10.1016/s0035-3787(06)75046-9.
Chronic inflammatory demyelinating polyneuropathy (CIDP) was proposed by Dyck et al. in 1975. Diagnosis was based mainly on nerve biopsy features with segmental demyelination, onion bulb formation and inflammatory infiltrates. In many pathological studies, frequencies of these features of CIDP were not observed in the same percentages. Limitations on the nerve biopsy were explained by the study of small, distal, only sensory nerve specimens in the lower limb. In recent years, the usefulness of nerve biopsy has been reconsidered. If electron microscopy and teased-fiber studies are used, the examination can recognize CIDP erroneously classified as chronic idiopathic axonal polyneuropathy. Therapeutic options should be guided by suggestive abnormalities of demyelination and or inflammation on nerve biopsy even in the presence of a electrophysiologic axonal pattern.
慢性炎症性脱髓鞘性多发性神经病(CIDP)由戴克等人于1975年提出。诊断主要基于神经活检特征,包括节段性脱髓鞘、洋葱球形成和炎性浸润。在许多病理学研究中,CIDP这些特征的出现频率并不相同。对下肢小的、远端的、仅感觉神经标本的研究解释了神经活检的局限性。近年来,神经活检的实用性已被重新审视。如果使用电子显微镜和 teased-fiber 研究,该检查可能会将错误分类为慢性特发性轴索性多发性神经病的CIDP识别出来。即使存在电生理轴索模式,治疗选择也应以神经活检中脱髓鞘和/或炎症的提示性异常为指导。