儿童及青少年腓总神经病变的电生理特征

Electrophysiologic features of fibular neuropathy in childhood and adolescence.

作者信息

Karakis Ioannis, Khoshnoodi Mohammad, Liew Wendy, Nguyen Elizabeth S, Jones H Royden, Darras Basil T, Kang Peter B

机构信息

Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Department of Neurology, Lahey Clinic, Burlington, Massachusetts, USA.

出版信息

Muscle Nerve. 2017 May;55(5):693-697. doi: 10.1002/mus.25403. Epub 2017 Jan 24.

DOI:10.1002/mus.25403

PMID:27615598

Abstract

INTRODUCTION

We studied patterns of nerve injury in pediatric common fibular (peroneal) neuropathy (CFN).

METHODS

A retrospective analysis was performed on data from 53 children with CFN at a pediatric electromyography laboratory.

RESULTS

Conduction block at the fibular head was present in 35% of patients. Deep fibular axonal loss was identified in 77%, while superficial fibular axonal loss was identified in 45%. The pathophysiology was predominantly axonal in 72%, mostly demyelinating in 6%, and mixed in 22%. Predominantly demyelinating lesions at the fibular head demonstrated sparing of the superficial fibular sensory nerve (P = 0.01, Fischer exact test). Predominantly axonal lesions had a moderate correlation between superficial and deep fibular axonal loss (Spearman r = 0.52; P = 0.0001).

CONCLUSIONS

There is frequent axonal and fascicular injury in pediatric CFN, similar to adults. Deep and superficial fibular nerve involvements correlate in axonal lesions, whereas superficial fibular sensory fibers are often spared in demyelinating lesions. Muscle Nerve, 2016 Muscle Nerve 55: 693-697, 2017.

摘要

引言

我们研究了小儿腓总神经病变（CFN）中的神经损伤模式。

方法

对一家小儿肌电图实验室的53例CFN患儿的数据进行回顾性分析。

结果

35%的患者在腓骨头处存在传导阻滞。77%的患者存在腓深神经轴突损失，45%的患者存在腓浅神经轴突损失。72%的患者病理生理学主要为轴索性，6%主要为脱髓鞘性，22%为混合型。腓骨头处主要为脱髓鞘性病变者显示腓浅感觉神经未受累（P = 0.01，Fisher确切概率检验）。主要为轴索性病变者，腓浅和腓深神经轴突损失之间存在中度相关性（Spearman相关系数r = 0.52；P = 0.0001）。