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丙烯酰胺所致中毒性周围神经病的临床、电生理特点及治疗

[Clinical and electrophysiological features and treatment of acrylamide-induced toxic peripheral neuropathy].

作者信息

Xu C W, Wu H F, Chen J

机构信息

Department of Neurology, Jinhua Municipal Central Hospital, Jinhua 321000, China.

Department of Electroneurophysiology, Jinhua Municipal Central Hospital, Jinhua 321000, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Jan 20;38(1):45-47. doi: 10.3760/cma.j.issn.1001-9391.2020.01.010.

Abstract

To investigate the clinical manifestations, electrophysiology results, treatment and prognosis of acrylamide-induced toxic peripheral neuropathy. The clinical data of 9 patients with acrylamide-induced toxic peripheral neuropathy, who were collected in Jinhua Municipal Central Hospital from January 2015 to August 2018, were retrospectively reviewed. This disease was characterized by distal limb numbness, some patients with hypoalgesia or allergy, deep sense loss, reduction or disappearance of tendon reflexes, and peeling. One case had muscle weakening and another case had cerebellar ataxia. Examination of electromyography showed only one case had spontaneous potential. Examination of nerve conduction showed that the amplitude decreased by 34 (38.6%) and the velocity decreased by 2 (2.3%) , the percentage of amplitude decreased was significantly higher than that of velocity decreased. The amplitude of sensory nerve decreased by 30 (57.7%) and motor nerve decreased by 4 (11.1%) , the percentage of sensory nerve amplitude decreased was significantly higher than that of motor nerve. After the treatment of nutrition, circulation improvement, numbness relief, glucocorticoid and other drugs, the numbness of the patients was relieved, but it did not completely disappear. Poor recovery of pain, deep sensation and tendon reflex in all patients. The results of reexamination of electromyography in 3 cases were worse than before. Therefore, it is suggested that peripheral nerve damage is irreversible. This disease is characterized by distal limb numbness. Electrophysiological results suggest that the damage of sensory nerve axon is the main cause of the disease. Up to now, there is no effective drug to treat this disease, therefore, it is very important to do a good job of protection.

摘要

探讨丙烯酰胺中毒性周围神经病的临床表现、电生理结果、治疗及预后。回顾性分析2015年1月至2018年8月在金华市中心医院收治的9例丙烯酰胺中毒性周围神经病患者的临床资料。该病以肢体远端麻木为特征,部分患者有痛觉减退或过敏、深感觉障碍、腱反射减弱或消失,以及皮肤脱屑。1例有肌肉无力,另1例有小脑共济失调。肌电图检查仅1例有自发电位。神经传导检查示波幅下降34例(38.6%),速度下降2例(2.3%),波幅下降百分比明显高于速度下降百分比。感觉神经波幅下降30例(57.7%),运动神经波幅下降4例(11.1%),感觉神经波幅下降百分比明显高于运动神经。经营养、改善循环、减轻麻木、糖皮质激素等药物治疗后,患者麻木症状缓解,但未完全消失。所有患者疼痛、深感觉及腱反射恢复差。3例复查肌电图结果较前变差。提示周围神经损伤不可逆。该病以肢体远端麻木为特征。电生理结果提示感觉神经轴索损害是本病的主要原因。目前尚无有效治疗药物,因此做好防护工作非常重要。

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