Werner R A, Wolf L L
Department of PM&R, University of Michigan Medical Center, Ann Arbor 48109-0042.
Arch Phys Med Rehabil. 1990 May;71(6):433-5.
This case report documents the natural history of the peripheral polyneuropathy associated with persistent hypereosinophilia after treatment with corticosteroids. The neuropathy was documented by nerve conduction studies which revealed reduced amplitude of the sensory and motor evoked responses and slowed conduction velocities that were consistent with axon loss. Sural nerve biopsy revealed mild axonal loss distally without eosinophilic infiltration. The patient was treated with high-dose corticosteroids with a rapid normalization of his eosinophil count. Neurologic examination six months later revealed a slight improvement in his motor strength and reflexes but no change in sensory functions. Follow-up electromyographic evaluation demonstrated an average 89% improvement in evoked potential amplitudes and a slight improvement in distal latencies and conduction velocities. These findings suggest that the neuropathy associated with hypereosinophilia is axonal in nature and that there is a temporal relationship between reduction in the absolute eosinophil count and the improvement of the neuropathy.
本病例报告记录了皮质类固醇治疗后持续性嗜酸性粒细胞增多症相关的周围性多发性神经病的自然病程。神经传导研究记录了该神经病，结果显示感觉和运动诱发电位的波幅降低，传导速度减慢，这与轴突损失一致。腓肠神经活检显示远端轻度轴突损失，无嗜酸性粒细胞浸润。该患者接受了高剂量皮质类固醇治疗，嗜酸性粒细胞计数迅速恢复正常。6个月后的神经学检查显示其肌力和反射略有改善，但感觉功能无变化。随访肌电图评估显示诱发电位波幅平均改善89%，远端潜伏期和传导速度略有改善。这些发现表明，与嗜酸性粒细胞增多症相关的神经病本质上是轴索性的，并且绝对嗜酸性粒细胞计数的降低与神经病的改善之间存在时间关系。
