Pardal-Fernandez José M, Godes-Medrano Begoña, Sánchez-Ayaso Pedro, Rodríguez-Vázquez María, Iñíguez-De Onzoño Luis
Unidad de Electromiografía Clínica, Servicio de Neurofisiología, Albacete, España.
Rev Neurol. 2011 Jul 1;53(1):22-6.
Multiple mononeuritis is one of the most frequent manifestations of Churg-Strauss syndrome.
We describe a case of acute sensory-motor multiple mononeuritis in all four limbs of a 53-year-old male with Churg-Strauss syndrome. Electrodiagnosis performed within the first seven days revealed conduction blocks in several nerves. Follow-up studies showed diffuse bilateral sensory-motor axonal polyneuropathy with symmetries, but without blocks. Electrophysiological and histological analyses, together with experimental studies, showed it to be an axonopathy secondary to acute ischaemia.
In only a few cases, such as this one and in a small number of incipient studies, have there been reports of conduction blocks that, owing to the fact that they are commonly related with demyelination, give rise to confusion when it comes to diagnoses and prognoses. The condition usually displays axonopathy due to Wallerian degeneration. It therefore seems recommendable in these cases to proceed with caution and to perform neurophysiological studies in the following weeks in order to prevent inappropriate diagnostic and prognostic judgements from being formed.
多发性单神经炎是变应性肉芽肿性血管炎最常见的表现之一。
我们描述了一名53岁患有变应性肉芽肿性血管炎的男性患者，其四肢出现急性感觉运动性多发性单神经炎。在发病的前七天内进行的电诊断显示多条神经存在传导阻滞。随访研究显示为弥漫性双侧感觉运动性轴索性多发神经病，呈对称性，但无传导阻滞。电生理和组织学分析以及实验研究表明，这是一种继发于急性缺血的轴索性病变。
仅在少数情况下，如本病例以及少数初步研究中，有关于传导阻滞的报道，由于其通常与脱髓鞘有关，在诊断和预后判断方面会引起混淆。该病通常表现为沃勒变性所致的轴索性病变。因此，在这些病例中，谨慎行事并在接下来的几周内进行神经生理学研究似乎是可取的，以防止形成不恰当的诊断和预后判断。
