Cruz Martínez A, Villoslada C
Hospital La Paz, Clínica La Luz, Madrid, Spain.
Electromyogr Clin Neurophysiol. 1991 Oct-Nov;31(7):407-14.
Clinical and electrophysiologic features in 22 patients with HIV infection are reported. Four cases had chronic demyelinating polyneuropathy, two mononeuropathy multiplex, and nine symmetrical sensory-motor polyneuropathy. Seven cases had normal clinical and electromyographic examination. Electrophysiological study had a higher diagnostic yield (68%) than clinical examination (50%) for peripheral neuropathy diagnosis. Thus, peripheral nerve abnormalities are frequent in patients with different stages of HIV infection, although their pathogenesis remains unclear. Symmetrical sensory-motor polyneuropathy is the main type of neuropathy seen in ouvert AIDS, whereas chronic demyelinating polyneuropathy was mainly diagnosed in patients with asymptomatic HIV infection as first manifestation of the disease. Axonal or demyelinating nerve damage was established according to electrophysiological criteria. Frequently a mixture of both lesions was found. Electrophysiologic study is also a good index of neuropathy evolution in HIV infection and to follow-up of nerve abnormalities after treatment.
报告了22例HIV感染患者的临床和电生理特征。4例患有慢性脱髓鞘性多发性神经病,2例患有多发性单神经病,9例患有对称性感觉运动性多发性神经病。7例临床和肌电图检查正常。对于周围神经病变的诊断,电生理研究的诊断率(68%)高于临床检查(50%)。因此,尽管其发病机制尚不清楚,但周围神经异常在HIV感染不同阶段的患者中很常见。对称性感觉运动性多发性神经病是开放性艾滋病中所见的主要神经病变类型,而慢性脱髓鞘性多发性神经病主要在无症状HIV感染患者中作为疾病的首发表现被诊断出来。根据电生理标准确定轴索性或脱髓鞘性神经损伤。经常发现两种病变混合存在。电生理研究也是HIV感染中神经病变进展以及治疗后神经异常随访的良好指标。