Schlotter-Weigel B
Friedrich-Baur-Institut, Neurologische Klinik, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336, München, Deutschland.
Internist (Berl). 2020 Mar;61(3):261-269. doi: 10.1007/s00108-020-00755-7.
Vasculitic neuropathies result from inflammation of the vasa nervorum followed by ischemia and destruction of the peripheral nerve. The inflammation can be systemic or localized, i.e. non-systemic. Systemic vasculitis can be divided into primary and secondary forms. The latter is associated with, e.g. connective tissue diseases, infections, cancer or induced by certain drugs. Around two thirds of patients with systemic vasculitis develop vasculitic neuropathy presenting as characteristic painful, multifocal mononeuropathy of acute onset. The group of non-systemic neuropathies has grown in recent years with the addition of diabetic and non-diabetic lumbosacral radiculoplexus neuropathies, among others. Within the group of connective tissue diseases, other non-vasculitic neuropathies can occur as nerve-entrapment syndromes and sensory ataxic neuropathy. The aim of this article is to present a condensed overview of neuropathies associated with vasculitis and connective tissue diseases and to communicate characteristic clinical symptoms supporting rapid diagnostic and therapeutic procedures.
血管炎性神经病是由神经滋养血管炎症继发局部缺血和周围神经破坏所致。炎症可为全身性或局限性,即非全身性。系统性血管炎可分为原发性和继发性。后者与结缔组织病、感染、癌症或某些药物诱发有关。约三分之二的系统性血管炎患者会出现血管炎性神经病,表现为特征性的急性起病的疼痛性多灶性单神经病。近年来,随着糖尿病性和非糖尿病性腰骶神经根丛神经病等疾病的增加,非系统性神经病的范畴有所扩大。在结缔组织病中,其他非血管炎性神经病可表现为神经卡压综合征和感觉性共济失调性神经病。本文旨在简要概述与血管炎和结缔组织病相关的神经病,并介绍有助于快速诊断和治疗的特征性临床症状。