Krogias Christos, Ayzenberg Ilya, Schroeder Christoph, Grüter Thomas, Gold Ralf, Yoon Min-Suk
Dept. of Neurology, St. Josef-Hospital, Ruhr University Bochum, Germany.
Dept. of Neurology, St. Josef-Hospital, Ruhr University Bochum, Germany.
J Neurol Sci. 2016 Mar 15;362:206-8. doi: 10.1016/j.jns.2016.01.049. Epub 2016 Jan 22.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired, chronic progressive or relapsing immune mediated disorder of the peripheral nervous system. Thickening of cranial nerves as a sign of central nerve involvement is increasingly reported in the last years. Our aim was to assess systematically for the first time the frequency of optic nerve hypertrophy in patients with CIDP by means of transorbital sonography (TOS). Thirty-four optic nerves of 17 patients with CIDP (age=60.8±13.3y, range=39-82y; 7 female) were examined by TOS. The diameter of Optic nerve (OND) as well as the intern and extern diameters of the sheath (ONDSi, ONSDe) was measured 3mm behind the optic disc. Findings were compared to the data of 15 healthy controls. CIDP-patients showed a mean OND of 2.8±0.4mm, an ONSDi of 4.7±0.7mm, and an ONSDe of 6.3±0.9mm. No papilledema was detectable. There was no significant difference to the healthy control group. Our study revealed no evidence for a frequent optic nerve involvement in CIDP. Reported cases seem to represent exceptions. Transorbital sonography could be a useful tool in these rare cases with optic nerve hypertrophy.
慢性炎症性脱髓鞘性多发性神经根神经病（CIDP）是一种获得性、慢性进行性或复发性的免疫介导的周围神经系统疾病。近年来，越来越多的报道称颅神经增粗是中枢神经受累的表现。我们的目的是首次通过经眶超声检查（TOS）系统评估CIDP患者视神经肥大的发生率。对17例CIDP患者（年龄=60.8±13.3岁，范围=39 - 82岁；7名女性）的34条视神经进行了TOS检查。在视盘后3mm处测量视神经直径（OND）以及视神经鞘的内径和外径（ONDSi、ONSDe）。将结果与15名健康对照者的数据进行比较。CIDP患者的平均OND为2.8±0.4mm，ONDSi为4.7±0.7mm，ONSDe为6.3±0.9mm。未检测到视乳头水肿。与健康对照组无显著差异。我们的研究未发现CIDP患者频繁出现视神经受累的证据。报道的病例似乎是例外情况。经眶超声检查在这些罕见的视神经肥大病例中可能是一种有用的工具。
