Unit of Neurology, Neurobiology, Department of Medicine, University Campus Bio-Medico of Rome, via Álvaro del Portillo, 21, 00128, Rome, Italy.
IRCCS, UOC Neurologia, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy.
Neurol Sci. 2019 Aug;40(8):1611-1617. doi: 10.1007/s10072-019-03899-z. Epub 2019 Apr 18.
Chronic neuropathies are a common cause of neurological disability worldwide. However, few reports have evaluated, in real life, the prevalence of the several conditions which can cause it.
The authors reviewed informatic database for outpatient office to confirm identification of chronic neuropathy in a 3-year interval period.
Among the 100 selected patients with chronic neuropathies, almost one fifth (19%) remained idiopathic. The most common etiologies were diabetes (17%), dysimmune neuropathies (38%), and vitamin B12 deficiency (9%). In the "dysimmune neuropathies" group, we distinguished various etiologies, including dysimmune neuropathies associated or not with systemic autoimmune diseases (7 and 3%, respectively), chronic inflammatory polyneuropathy (CIDP) (8%), multifocal motor neuropathy (MMN) (3%), paraproteinemic (8%), celiac disease-related (6%), and paraneoplastic (3%) neuropathies.
In this report from a single neurological center, treatable causes of chronic neuropathies, such as dysimmune neuropathies, including CIDP, and celiac disease-associated neuropathy, were common. These findings suggest the utility of routine screening with blood testing for dysimmune neuropathy and celiac disease for all patients presenting with idiopathic chronic polyneuropathy in whom primary diagnostic testings had failed to identify an etiology for the disease.
Our results indicate that patients with peripheral neuropathy could receive a benefit from being evaluated routinely in a specialized neurological center, as many of the conditions that were discovered represented potentially treatable causes of neuropathy.
慢性神经病变是全球范围内导致神经功能障碍的常见原因。然而,在现实生活中,很少有报道评估可能导致其发生的几种疾病的患病率。
作者回顾了门诊办公室的信息数据库,以确认在 3 年的时间间隔内是否存在慢性神经病变。
在 100 名患有慢性神经病变的患者中,近五分之一(19%)仍为特发性。最常见的病因是糖尿病(17%)、免疫性神经病变(38%)和维生素 B12 缺乏症(9%)。在“免疫性神经病变”组中,我们区分了各种病因,包括与自身免疫性疾病相关或不相关的免疫性神经病变(分别为 7%和 3%)、慢性炎症性多神经病(CIDP)(8%)、多灶性运动神经病(MMN)(3%)、副蛋白血症(8%)、乳糜泻相关(6%)和副肿瘤性(3%)神经病变。
在这个来自单一神经中心的报告中,可治疗的慢性神经病变病因,如免疫性神经病变,包括 CIDP 和乳糜泻相关神经病,很常见。这些发现表明,对于所有表现为特发性慢性多发性神经病且原发性诊断检测未能确定病因的患者,常规进行免疫性神经病和乳糜泻血液检测筛查是有用的。
我们的结果表明,周围神经病变患者可以从专门的神经中心的常规评估中获益,因为发现的许多病症都代表了潜在可治疗的神经病变原因。