Vallat Jean-Michel, Richard Laurence, Sindou Philippe, Magy Laurent
Service de neurologie, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France.
Ann Pathol. 2008 Dec;28(6):486-94. doi: 10.1016/j.annpat.2008.04.006. Epub 2008 Nov 17.
Ultrastructural examination of a peripheral nerve biopsy may be particularly useful and sometimes indispensable for identification of the type of nerve lesion and of the aetiologies of peripheral neuropathies. The ultrastructural findings have, anyway, to be correlated with the clinical findings, the electrophysiological examination and the laboratory investigations. In this presentation, the various causes of peripheral neuropathies for which nerve biopsy study by electron microscope can provide diagnostic information are discussed. The principal aetiologies that will benefit from such an ultrastructural study are toxic, infectious, haemopathic and storage disorders. Chiefly for Charcot-Marie-Tooth sporadic cases, there are still indications for nerve biopsy to orientate diagnostic research in molecular biology. Sometimes, the electron microscopic examination will help to determine not only the cause of the peripheral neuropathy, but also the mechanism of nerve lesions which may induce specific and efficient treatments.
对周围神经活检进行超微结构检查,对于识别神经病变类型及周围神经病变的病因可能特别有用,有时甚至必不可少。无论如何,超微结构检查结果都必须与临床检查结果、电生理检查及实验室检查结果相关联。在本报告中,将讨论通过电子显微镜进行神经活检研究可为其提供诊断信息的各种周围神经病变病因。可从这种超微结构研究中受益的主要病因包括中毒性、感染性、血液性及贮积性疾病。主要针对夏科-马里-图斯散发型病例,仍有进行神经活检以指导分子生物学诊断研究的指征。有时,电子显微镜检查不仅有助于确定周围神经病变的病因,还能确定神经病变的机制,从而可能引出针对性强且有效的治疗方法。