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慢性特发性轴索性多发性神经病:真的良性吗?

Chronic axonal idiopathic polyneuropathy: is it really benign.

机构信息

Department of Neurology, Karolinska University Hospital.

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

出版信息

Curr Opin Neurol. 2020 Oct;33(5):562-567. doi: 10.1097/WCO.0000000000000847.

Abstract

PURPOSE OF REVIEW

Chronic idiopathic axonal polyneuropathy (CIAP), a common neurological condition, is considered to be a benign neurological condition with a small risk of disability. However, many studies have shown a reduced quality of life and a nonnegligible affection of daily activities in patients with CIAP. Here we summarize recent data about CIAP.

RECENT FINDINGS

We discuss some of the latest articles regarding risk factors, comorbidities, and possible pathogenic factors regarding CIAP. Patients with chronic polyneuropathy have impaired walking capacity, disturbed balance, and an increased risk of falls. Idiopathic polyneuropathy has a negative impact on activities of daily living. Patients with CIAP may develop plantar ulcers and neuropathic arthropathy. Small fiber involvement may occur, and two recent studies indicate that neuropathic pain is present in about two thirds of the CIAP group. Furthermore, patients with CIAP with neuropathic pain have increased fatigue and poorer emotional well being.

SUMMARY

Despite the relatively mild motor impairment seen in most patients with CIAP, the condition causes limitations in life with decreased mobility, pain, and affection of basal daily activities. Because the pathogenesis of CIAP in unclear, there is no disease modifying treatment. Further studies regarding pathogenesis, and randomized controlled clinical trials regarding possible treatment options are needed.

摘要

目的综述

慢性特发性轴索性神经病(CIAP)是一种常见的神经疾病,被认为是一种良性神经疾病,残疾风险较小。然而,许多研究表明,CIAP 患者的生活质量降低,日常活动受到不小的影响。本文总结了 CIAP 的最新研究数据。

最近发现

我们讨论了一些关于 CIAP 的最新文章,包括危险因素、合并症和可能的发病因素。慢性多发性神经病患者的步行能力受损,平衡能力受到干扰,跌倒风险增加。特发性多发性神经病对日常生活活动有负面影响。CIAP 患者可能会出现足底溃疡和神经病理性关节炎。小纤维受累可能会发生,最近的两项研究表明,大约三分之二的 CIAP 患者存在神经病理性疼痛。此外,有神经病理性疼痛的 CIAP 患者疲劳感增加,情绪健康状况较差。

总结

尽管大多数 CIAP 患者的运动功能损伤相对较轻,但该疾病会导致活动受限、疼痛和日常生活基本活动受影响,从而降低生活质量。由于 CIAP 的发病机制尚不清楚,因此目前没有针对该疾病的治疗方法。需要进一步研究发病机制,并开展针对可能的治疗选择的随机对照临床试验。

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