长春新碱诱发的神经病变：儿童中的非典型电生理模式
Vincristine-induced neuropathy: Atypical electrophysiological patterns in children.
作者信息
Courtemanche Hélène, Magot Armelle, Ollivier Yolaine, Rialland Fanny, Leclair-Visonneau Laurène, Fayet Guillemette, Camdessanché Jean-Philippe, Péréon Yann
机构信息
Laboratoire d'Explorations Fonctionnelles, Hôtel-Dieu, CHU de Nantes, 44093, Nantes, France.
Centre de Référence Maladies Neuromusculaires Nantes Angers, CHU de Nantes, Nantes, France.
出版信息
Muscle Nerve. 2015 Dec;52(6):981-5. doi: 10.1002/mus.24647. Epub 2015 Sep 12.
INTRODUCTION
Vincristine is an antimitotic agent used for treatment of leukemia, lymphomas, and cancers. Its main side effect is a dose-related, length-dependent (LD) axonal neuropathy.
METHODS
We performed electrodiagnostic (EDx) examinations in 17 children who had been treated with vincristine and who presented with the clinical picture of a peripheral neuropathy.
RESULTS
The mean dose of vincristine was 8.5 ± 4.0 mg/m(2) . Clinical motor symptoms were more frequent and more severe than sensory ones. Thirteen children presented with a motor deficit, 4 of whom could no longer walk. EDx examination showed an axonal neuropathy with a non-length-dependent (NLD) pattern in 9 children and an LD pattern in 8. A major motor predominance was encountered in 12 patients.
CONCLUSIONS
The electrophysiological and clinical motor predominance described differs from the mainly sensory neuropathy reported in adults. Incomplete myelination due to young age may have resulted in greater sensitivity of some nerves to neurotoxic agents.
引言
长春新碱是一种用于治疗白血病、淋巴瘤和癌症的抗有丝分裂药物。其主要副作用是与剂量相关的、长度依赖性（LD）轴索性神经病。
方法
我们对17名接受过长春新碱治疗且出现周围神经病临床表现的儿童进行了电诊断（EDx）检查。
结果
长春新碱的平均剂量为8.5±4.0mg/m²。临床运动症状比感觉症状更频繁、更严重。13名儿童出现运动功能障碍，其中4名无法行走。EDx检查显示，9名儿童为非长度依赖性（NLD）模式的轴索性神经病，8名儿童为LD模式。12例患者以运动功能障碍为主。
结论
所描述的电生理和临床运动功能障碍为主的情况与成人中主要为感觉性神经病的报道不同。由于年龄小导致的髓鞘形成不完全可能使某些神经对神经毒性药物更敏感。
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