de Freitas M R, Chimelli L, Nascimento O J, Barbosa G M
Departamentos de Medicina Clínica e de Patologia, Faculdade de Medicina, Universidade Federal Fluminense.
Arq Neuropsiquiatr. 1989 Jun;47(2):235-40. doi: 10.1590/s0004-282x1989000200017.
A case of a young man who presented symptoms and clinical signs of polyneuropathy that occurred in connection with recurrent hypoglycemic episodes is reported. The hypoglycemia was probably caused by a pancreatic islet tumor. There were symmetric weakness and wasting of hands and feet, absent tendon reflexes and 'glove and stocking' loss of sensation. Electromyographic studies showed denervation potentials with slight reduction of nerve conduction velocities. Sural nerve biopsy studied by optic and electronic microscopy showed axonal degeneration without signs of demyelination or remyelination. There are only 30 similar cases reported in the literature. According to experimental findings, the authors believe that glucopenia is the mechanism responsible for the development of the neuropathy, and that at present time there is no evidence for a direct insulin effect.
报告了一例与反复低血糖发作相关的出现多神经病症状和体征的年轻男性病例。低血糖可能由胰岛肿瘤引起。存在双手和双脚的对称性无力及肌肉萎缩、腱反射消失和“手套袜套样”感觉丧失。肌电图研究显示失神经电位，神经传导速度略有降低。经光学和电子显微镜检查的腓肠神经活检显示轴突变性，无脱髓鞘或再髓鞘化迹象。文献中仅报道了30例类似病例。根据实验结果，作者认为低血糖是导致神经病变发展的机制，目前尚无证据表明存在直接的胰岛素作用。
