Morkavuk G, Leventoglu A
Ufuk University Medical School, Department of Neurology, Mevlana Bulvarı No. 86-88, Balgat, 06500 Ankara, Turkey.
ISRN Neurol. 2014 Mar 19;2014:579242. doi: 10.1155/2014/579242. eCollection 2014.
Background. Established electrophysiological methods have limited clinical utility in the diagnosis of small fiber neuropathy. The cutaneous silent period (CSP) may be useful as a method for the evaluation of smaller and unmyelinated fiber dysfunctions. Hyperlipidemia is a very rare cause of small fiber neuropathy. In this study, hyperlipidemia and small fiber neuropathy in symptomatic patients with normal nerve conduction studies were evaluated with autonomic tests and cutaneous silent periods. Methods. Twenty-five patients with clinically suspected small fiber neuropathy and 23 healthy volunteers were included. CSP latency and duration, as well as CSP latency difference of the upper and lower extremities, were examined. Two tests were used to assess the autonomic nervous system, namely, the R-R interval variation test in basal and profound breath conditions and the sympathetic skin response. Results. Twenty-five patients with clinically suspected small fiber neuropathy and normal nerve conduction studies were compared with 23 controls. In the upper extremities, patients had prolonged CSP latencies (P = 0.034) and shortened CSP durations (P = 0.039), whereas in the lower extremities, patients had shortened CSP durations (P = 0.001). The expiration-to-inspiration ratios were also reduced in patients groups. There was no significant difference between sympathetic skin response latencies and amplitude of the case and control groups. Conclusion. Our findings indicate that CSP may become a useful technique for the assessment of small fiber neuropathy in hyperlipidemic patients.
背景。已确立的电生理方法在小纤维神经病变的诊断中临床应用有限。皮肤静息期（CSP）可能作为一种评估较细和无髓鞘纤维功能障碍的方法。高脂血症是小纤维神经病变非常罕见的病因。在本研究中，通过自主神经测试和皮肤静息期对有症状但神经传导研究正常的患者的高脂血症和小纤维神经病变进行评估。方法。纳入25例临床疑似小纤维神经病变的患者和23名健康志愿者。检测CSP潜伏期和持续时间，以及上下肢CSP潜伏期差异。使用两项测试评估自主神经系统，即基础和深呼吸状态下的R-R间期变异性测试以及交感皮肤反应。结果。将25例临床疑似小纤维神经病变且神经传导研究正常的患者与23名对照进行比较。在上肢，患者的CSP潜伏期延长（P = 0.034）且CSP持续时间缩短（P = 0.039），而在下肢，患者的CSP持续时间缩短（P = 0.001）。患者组的呼气与吸气比值也降低。病例组和对照组的交感皮肤反应潜伏期和波幅无显著差异。结论。我们的研究结果表明，CSP可能成为评估高脂血症患者小纤维神经病变的一种有用技术。
