Laterre C, Ghilain S, Tassin S, Guérit J M
Université Catholique de Louvain, Bruxelles.
Rev Neurol (Paris). 1988;144(5):358-64.
We studied ten cases of disseminated sensory neuropathy. Both sexes were similarly involved. Except in one case, the first symptoms appeared between ages 20 and 50. The clinical disorders, their evolution and similar cases previously reported suggest and autonomous benign disease. The deficits resulted from a selective involvement of superficial cutaneous nervous fibers and appeared in different cutaneous areas. Some territories were more frequently affected (nervus peroneus, sural, radialis, cutaneous femoralis lateralis). Tinel's sign was often present. Patients sometimes described a sensation of electric discharge when elongating nerve trunks. In half of the cases the attacks of dysesthesia or of sensory loss followed one another within less than one year. The deficits were fully reversible in a third of the cases after a mean total evolution of 4 to 8 years. Blood and cerebrospinal fluid were always normal. Electromyography and motor conduction velocities were normal. Sensory conduction velocities were uncommonly decreased. On the other hand, the aspect of somesthetic potentials which were evoked from cutaneous areas involved by the disease were modified in most cases. Pathological examination of nerve biopsies which were performed in 5 cases showed non specific axo-myelinic degeneration in 3 cases and a severe sclerosis of the perineurium in one case. The etiopathogenesis of the disease is discussed.
我们研究了10例播散性感觉神经病患者。男女受累情况相似。除1例患者外,首发症状均出现在20至50岁之间。临床症状、病情演变以及先前报道的类似病例提示这是一种自主性良性疾病。这些功能障碍是由浅表皮肤神经纤维的选择性受累引起的,且出现在不同的皮肤区域。某些部位更常受累(腓总神经、腓肠神经、桡神经、股外侧皮神经)。Tinel征常呈阳性。患者有时会描述在牵拉神经干时有一种放电感。半数病例中,感觉异常或感觉丧失发作在不到1年的时间内相继出现。三分之一的病例在平均总病程4至8年后,功能障碍完全可逆。血液和脑脊液检查始终正常。肌电图和运动传导速度正常。感觉传导速度罕见降低。另一方面,在大多数病例中,由疾病累及的皮肤区域诱发的躯体感觉电位的表现有所改变。对5例患者进行的神经活检病理检查显示,3例为非特异性轴索 - 髓鞘变性,1例为严重的神经束膜硬化。本文对该疾病的病因发病机制进行了讨论。