Köşkderelioğlu Aslı, Ortan Pınar, Ari Alpay, Gedizlioğlu Muhteşem
Clinic of Neurology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
Clinic of Infectious Diseases, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
Noro Psikiyatr Ars. 2016 Mar;53(1):23-27. doi: 10.5152/npa.2015.10218. Epub 2016 Mar 1.
To investigate the existence of peripheral and optic neuropathies in asymptomatic individuals with hepatitis C infection.
Thirty consecutive patients who were followed in a hepatitis C outpatient clinic were recruited for electrophysiological evaluation together with 30 age- and gender-compatible healthy controls. All patients had a detailed neurological examination. The information regarding the disease duration and management with interferons were collected. Nerve conduction studies and visual evoked potentials (VEP) were recorded in all subjects. The results of the patient and control groups were statistically compared.
Of the patients with hepatitis C infection, 16 were females and 14 males. The mean age was 57.5 years, and the average disease duration was 6.43 years. The P100 latencies in the patient group were within normal limits, while the amplitudes were meaningfully small by comparison with the controls. There were some abnormalities in the nerve conduction studies of 15 patients. Sensorial neuropathy was detected in two patients, sensorimotor polyneuropathy in four, carpal tunnel syndrome in seven, and carpal tunnel syndrome and sensorimotor polyneuropathy as comorbid states in another two patients. The nerve conduction studies and VEP parameters were entirely normal in the control group.
Hepatitis C-related neurological abnormalities may occur both in the central and peripheral nervous system. Mononeuritis multiplex, sensorial axonal neuropathy, and multiple mononeuropathies are some of the presentations of the peripheral nervous system involvement. The mode of infection is considered to be via vasculitic mechanisms. In addition, optic neuropathy is a known complication of interferon treatment. Autoantibodies, cytokines, chemokines, and cryoglobulins are accused to play roles in the pathogenesis. In this study, we investigated the involvement of the peripheral nervous system and optic nerves in a group of patients with hepatitis C. The results were in favor of peripheral nerve injury of various types and optic neuropathy of the axonal type.
调查丙型肝炎感染无症状个体中周围神经病变和视神经病变的存在情况。
招募了在丙型肝炎门诊接受随访的30例连续患者，连同30例年龄和性别匹配的健康对照进行电生理评估。所有患者均接受了详细的神经系统检查。收集了有关疾病持续时间和干扰素治疗的信息。对所有受试者进行神经传导研究和视觉诱发电位（VEP）记录。对患者组和对照组的结果进行统计学比较。
丙型肝炎感染患者中，女性16例，男性14例。平均年龄为57.5岁，平均疾病持续时间为6.43年。患者组的P100潜伏期在正常范围内，但其波幅与对照组相比明显较小。15例患者的神经传导研究存在一些异常。2例患者检测出感觉神经病变，4例患者检测出感觉运动性多发性神经病变，7例患者检测出腕管综合征，另外2例患者同时存在腕管综合征和感觉运动性多发性神经病变。对照组的神经传导研究和VEP参数完全正常。
丙型肝炎相关的神经异常可能发生在中枢神经系统和周围神经系统。多发性单神经炎、感觉性轴索性神经病变和多发性单神经病变是周围神经系统受累表现的一部分。感染方式被认为是通过血管炎机制。此外，视神经病变是干扰素治疗的已知并发症。自身抗体、细胞因子、趋化因子和冷球蛋白被认为在发病机制中起作用。在本研究中，我们调查了一组丙型肝炎患者的周围神经系统和视神经受累情况。结果支持存在各种类型的周围神经损伤和轴索性视神经病变。
