Gardill Klaus, Schüpbach Michael
Neurologische Praxis, Mühledorfstraße 21, 3018, Bern, Schweiz.
Neurologisches Institut, Konolfingen, Schweiz.
Nervenarzt. 2021 Feb;92(2):161-165. doi: 10.1007/s00115-020-01020-w. Epub 2020 Oct 28.
The differential diagnosis of chronic demyelinating polyneuropathy particularly includes inflammatory (CIDP) and hereditary causes. Using the example of a 63-year-old patient, we show the diagnostic procedure with conventional electrophysiological diagnostics and additionally by the use of proximal nerve conduction studies with high-voltage stimulation (HVS) and the direct morphological examination by high-resolution nerve ultrasound. In the present case, the focal accentuation of the changes in HVS and the equally pronounced focal thickening of the most affected ulnar nerve in ultrasound confirmed the diagnosis of CIDP instead of hereditary neuropathy.
慢性脱髓鞘性多发性神经病的鉴别诊断尤其包括炎症性(慢性炎症性脱髓鞘性多发性神经病,CIDP)和遗传性病因。以一名63岁患者为例,我们展示了采用传统电生理诊断方法的诊断过程,此外还通过使用高压刺激(HVS)进行近端神经传导研究以及通过高分辨率神经超声进行直接形态学检查。在本病例中,高压刺激变化的局灶性加重以及超声检查中最受影响的尺神经同样明显的局灶性增粗,证实了诊断为慢性炎症性脱髓鞘性多发性神经病而非遗传性神经病。