Gabelle A, Vallat J M, Flageul B, Andre P, Camu W
Service de neurologie-explorations, CHU Gui-de-Chauliac, 80, avenue Augustin-Fliche, 34285 Montpellier cedex 05, France.
Rev Neurol (Paris). 2008 Nov;164(11):964-8. doi: 10.1016/j.neurol.2007.11.004. Epub 2008 May 12.
The diagnostic process of sensory-motor neuropathies is difficult. Atypical variants and rare etiologies also contribute to delay the diagnosis. We report the case of a 70-year-old woman with slowly progressive asymmetric axonal sensory-motor neuropathy. Leprosy was identified after an eight-year delay. Nerve biopsy was required to establish the diagnosis: electron microscopy revealed debris of Hansen's bacillus in the nerve. Treatment was fully curative after several months. Leprosy is a rare cause of neuropathy in Europeans. Systematic inquiry about travel to endemic areas would be helpful in establishing the diagnosis. In such cases, nerve biopsy is crucial.
感觉运动性神经病变的诊断过程颇具难度。非典型变异型和罕见病因也会导致诊断延迟。我们报告一例70岁女性患者,患有缓慢进展的不对称性轴索性感觉运动性神经病变。八年后才确诊为麻风病。需要进行神经活检来确诊:电子显微镜检查在神经中发现了麻风杆菌碎片。经过数月治疗,病情完全治愈。在欧洲人中,麻风病是神经病变的罕见病因。系统询问是否去过流行地区有助于确诊。在这种情况下,神经活检至关重要。