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易患压迫性麻痹的遗传性神经病的超声检查结果

Ultrasonographic findings in hereditary neuropathy with liability to pressure palsies.

作者信息

Bayrak Ayse O, Bayrak Ilkay Koray, Battaloglu Esra, Ozes Burcak, Yildiz Onur, Onar Musa Kazim

出版信息

Neurol Res. 2015 Feb;37(2):106-11. doi: 10.1179/1743132814Y.0000000411. Epub 2014 Jul 9.

Abstract

OBJECTIVES

The aims of this study were to evaluate the sonographic findings of patients with hereditary neuropathy with liability to pressure palsies (HNPP) and to examine the correlation between sonographic and electrophysiological findings.

METHODS

Nine patients whose electrophysiological findings indicated HNPP and whose diagnosis was confirmed by genetic analysis were enrolled in the study. The median, ulnar, peroneal, and tibial nerves were evaluated by ultrasonography.

RESULTS

We ultrasonographically evaluated 18 median, ulnar, peroneal, and tibial nerves. Nerve enlargement was identified in the median, ulnar, and peroneal nerves at the typical sites of compression. None of the patients had nerve enlargement at a site of noncompression. None of the tibial nerves had increased cross-sectional area (CSA) values. There were no significant differences in median, ulnar, and peroneal nerve distal motor latencies (DMLs) between the patients with an increased CSA and those with a normal CSA. In most cases, there was no correlation between electrophysiological abnormalities and clinical or sonographic findings.

DISCUSSION

Although multiple nerve enlargements at typical entrapment sites on sonographic evaluation can suggest HNPP, ultrasonography cannot be used as a diagnostic tool for HNPP. Ultrasonography may contribute to the differential diagnosis of HNPP and other demyelinating polyneuropathies or compression neuropathies; however, further studies are required.

摘要

目的

本研究旨在评估压力性麻痹易感性遗传性神经病(HNPP)患者的超声检查结果,并探讨超声与电生理检查结果之间的相关性。

方法

本研究纳入9例电生理检查结果提示HNPP且经基因分析确诊的患者。通过超声对正中神经、尺神经、腓总神经和胫神经进行评估。

结果

我们对18条正中神经、尺神经、腓总神经和胫神经进行了超声评估。在典型受压部位的正中神经、尺神经和腓总神经中发现了神经增粗。没有患者在非受压部位出现神经增粗。所有胫神经的横截面积(CSA)值均未增加。CSA增加的患者与CSA正常的患者之间,正中神经、尺神经和腓总神经的远端运动潜伏期(DML)无显著差异。在大多数情况下,电生理异常与临床或超声检查结果之间无相关性。

讨论

尽管超声评估发现典型卡压部位有多处神经增粗可能提示HNPP,但超声不能用作HNPP的诊断工具。超声可能有助于HNPP与其他脱髓鞘性多发性神经病或压迫性神经病的鉴别诊断;然而,仍需要进一步研究。

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