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[与中枢神经系统受累相关的慢性炎性脱髓鞘性多发性神经根神经病——与多发性硬化症的比较]

[Chronic inflammatory demyelinating polyradiculoneuropathy associated with central nervous system involvement--as compared to multiple sclerosis].

作者信息

Komori T, Ohtake T, Miyazaki Y, Hirose K, Tanabe H

机构信息

Department of Neurology, Tokyo Metropolitan Neurological Hospital.

出版信息

Rinsho Shinkeigaku. 1990 Sep;30(9):939-43.

PMID:2265502
Abstract

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with central nervous system (CNS) demyelinating lesions has recently been reported to mimic multiple sclerosis (MS). In this paper, a series of patients with CIDP were examined to see if they had CNS involvement. CIDP patients with CNS lesions were then compared to patients with MS with peripheral nervous system (PNS) involvement for similarities. CNS and PNS involvement were detected by clinical symptoms, neurological findings, neuro-otological and neuro-ophthalmological tests, electrophysiological examinations such as electroencephalography, evoked potentials, blink reflex, conventional peripheral nerve conduction studies and electromyography, as well as computed tomography and magnetic resonance imaging (MRI). There were 7 of 17 CIDP patients with CNS involvement, but only 2 of 59 MS patients with PNS lesions were found. The rate of CIDP with CNS involvement (41.2%) was higher than that of MS with PNS lesions (3.4%). The CNS signs and symptoms of 7 CIDP patients were not so constant as their PNS symptoms, and consisted of 1 case with optic neuritis, 4 cases with cerebellar atxia and/or nystagmus, and 3 cases with spinal symptoms. These signs and symptoms are all well known in MS. Prolonged latencies on evoked potentials and high signal white matter lesions on T2 weighted MRI, indicating demyelinating CNS lesions were also similar to those found in MS. The CNS involvement in those patients with CIDP was therefore similar in character to those found in MS, but was far less severe than the PNS finding.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

近期有报道称,伴有中枢神经系统(CNS)脱髓鞘病变的慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)可模仿多发性硬化症(MS)。本文对一系列CIDP患者进行检查,以确定他们是否存在CNS受累情况。然后将伴有CNS病变的CIDP患者与伴有周围神经系统(PNS)受累的MS患者进行相似性比较。通过临床症状、神经系统检查结果、神经耳科和神经眼科检查、脑电图、诱发电位、眨眼反射、传统周围神经传导研究和肌电图等电生理检查,以及计算机断层扫描和磁共振成像(MRI)来检测CNS和PNS受累情况。17例CIDP患者中有7例存在CNS受累,但59例伴有PNS病变的MS患者中仅发现2例。伴有CNS受累的CIDP发生率(41.2%)高于伴有PNS病变的MS发生率(3.4%)。7例CIDP患者的CNS体征和症状不如其PNS症状那样持续存在,包括1例视神经炎、4例小脑共济失调和/或眼球震颤,以及3例脊髓症状。这些体征和症状在MS中均很常见。诱发电位潜伏期延长以及T2加权MRI上的高信号白质病变,表明CNS脱髓鞘病变也与MS中发现的情况相似。因此,这些CIDP患者的CNS受累在特征上与MS患者相似,但远不如PNS表现严重。(摘要截断于250字)

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