Sawai Setsu, Misawa Sonoko, Kobayashi Makoto, Kanai Kazuaki, Isose Sagiri, Shibuya Kazumoto, Sekiguchi Yukari, Nasu Saiko, Noto Yuichi, Fujimaki Yumi, Koga Shunsuke, Ohtani Ryohei, Kuwabara Satoshi
Department of Neurology, Graduate School of Medicine, Chiba University.
Intern Med. 2010;49(5):471-4. doi: 10.2169/internalmedicine.49.2894. Epub 2010 Mar 1.
Peripheral neuropathy is a rare manifestation of sarcoidosis, and previous studies have shown axonal degeneration as the main pathology. We herein report three patients with sarcoidosis who presented with multiple mononeuropathy as the initial manifestation. Nerve conduction studies showed prominent multifocal conduction blocks in the intermediate nerve trunk. In all three patients, corticosteroid treatment resulted in a dramatic clinical improvement associated with rapid resolution of conduction blocks. The sequential electrodiagnostic findings suggest that demyelinative or ischemic-functional conduction block is responsible for their neuropathy. To date, only three cases of acute conduction block neuropathy associated with sarcoidosis have been reported, but it may occur more frequently than expected.
周围神经病变是结节病的一种罕见表现,既往研究表明轴索性变性是主要病理改变。我们在此报告3例以多发性单神经病为首发表现的结节病患者。神经传导检查显示正中神经干存在明显的多灶性传导阻滞。在所有3例患者中,皮质类固醇治疗使临床症状显著改善,同时传导阻滞迅速消失。连续的电诊断结果提示,脱髓鞘性或缺血性功能传导阻滞是导致其神经病变的原因。迄今为止,仅报道过3例与结节病相关的急性传导阻滞性神经病,但实际发生率可能高于预期。