Overell James R
Neurology Department, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow G51 4TF, UK.
Pract Neurol. 2011 Apr;11(2):62-70. doi: 10.1136/jnnp.2011.241612.
Long lists of causes of peripheral neuropathy make peripheral nerve disease a dry and uninspiring subject. A simple scheme based on the answers to just six questions should enable the clinician to recognise characteristic patterns, investigate relevant subgroups appropriately, and identify treatable disorders quickly: which systems are involved? What is the distribution of weakness? What is the nature of the sensory involvement? Is there any evidence of upper motor neuron involvement? What is the temporal evolution? Is there any evidence for a hereditary neuropathy? Standard screening investigations suffice for the common length dependent axonal neuropathies while complex presentations need more detailed investigations targeted to their clinical phenotype.
导致周围神经病变的病因繁多,这使得周围神经疾病成为一个枯燥且无趣的话题。基于只需回答六个问题的简单方案,临床医生应能够识别特征性模式,对相关亚组进行适当的调查,并迅速识别可治疗的疾病:哪些系统受累?肌无力的分布情况如何?感觉受累的性质是什么?是否有上运动神经元受累的证据?时间演变情况如何?是否有遗传性神经病变的证据?对于常见的长度依赖性轴索性周围神经病变,标准的筛查检查就足够了,而复杂的表现则需要针对其临床表型进行更详细的检查。