Kutlu Gulnihal, Ertem Gunay Tuncer, Coskun Ozlem, Ergun Ufuk, Gomceli Yasemin B, Tulek Necla, Inan Levent Ertugrul
Department of Neurology, Ankara Training & Research Hospital, Ministry of Health, Ankara, Turkey.
Eur Neurol. 2009;61(1):33-8. doi: 10.1159/000165347. Epub 2008 Oct 24.
Brucellosis is a common infectious disease in Mediterranean countries. We evaluated the peripheral nerve involvement in patients with brucellosis. Thirty-eight patients with brucellosis were examined. Four of them were excluded because of B(12) deficiency and diabetes mellitus. Thirty-four patients were included. The average age was 43.08 +/- 15.3 years. Patients were divided into two groups according to the abnormality in their peripheral nervous system (PNS) examination. All patients underwent nerve conduction and needle electromyography EMG studies. Twenty normal healthy subjects were used as a control group. Axonal sensorimotor neuropathy was determined in 12 patients who also had abnormality in PNS examination. After 6 months of treatment, nerve conduction studies were nearly normal in these patients. The EMG findings of the remaining 22 patients were normal, as well as the clinical examination. However, the motor conduction velocities of median (p < 0.001), peroneal (p < 0.001), and ulnar (p < 0.05) nerves were decreased, F wave latencies were prolonged in the posterior tibial and peroneal nerve, and distal latency was also prolonged in the posterior tibial nerve (p < 0.05) when compared to healthy subjects. Sensory conduction velocities of the median (p < 0.001), ulnar and sural (p < 0.05) nerve were also decreased. Brucellosis may be considered as a cause of clinical or subclinical peripheral neuropathy and should be evaluated especially in endemic areas.
布鲁氏菌病是地中海国家常见的传染病。我们评估了布鲁氏菌病患者的周围神经受累情况。对38例布鲁氏菌病患者进行了检查。其中4例因维生素B12缺乏和糖尿病被排除。纳入34例患者。平均年龄为43.08±15.3岁。根据周围神经系统(PNS)检查异常将患者分为两组。所有患者均接受了神经传导和针极肌电图(EMG)检查。选取20名正常健康受试者作为对照组。12例PNS检查也有异常的患者被诊断为轴索性感觉运动神经病。治疗6个月后,这些患者的神经传导检查基本恢复正常。其余22例患者的EMG检查结果及临床检查均正常。然而,与健康受试者相比,正中神经(p<0.001)、腓总神经(p<0.001)和尺神经(p<0.05)的运动传导速度降低,胫后神经和腓总神经的F波潜伏期延长,胫后神经的远端潜伏期也延长(p<0.05)。正中神经(p<0.001)、尺神经和腓肠神经(p<0.05)的感觉传导速度也降低。布鲁氏菌病可被视为临床或亚临床周围神经病变的一个病因,尤其在流行地区应进行评估。