Tian Jing, Cao Cuifang, Miao Ruihan, Wu Haoran, Zhang Kun, Wang Binbin, Zhou Zhou, Chen Ruomeng, Liu Xiaoyun
Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050061, China.
Neuroscience Research Center, Medicine and Health Institute, Hebei Medical University, Shijiazhuang 050011, China.
Brain Sci. 2022 Dec 2;12(12):1656. doi: 10.3390/brainsci12121656.
There are few clinical and electrophysiological studies on paraneoplastic neurological syndrome (PNS) with peripheral nerve damage, which brings great challenges to clinical identification and diagnosis. We analyzed the clinical and electrophysiological data of twenty-five confirmed PNS cases using peripheral nerve damage patients. The results showed the most common chief complaint was weakness (20/25, 80%), followed by numbness (13/25, 52%). Nineteen patients (76%) exhibited peripheral nervous system lesions prior to occult tumors, and the median time from symptom onset to the diagnosis of a tumor was 4 months. The electrophysiological results revealed a higher rate of abnormal amplitudes than latency or conduction velocity, especially in sensory nerves. Meanwhile, we found that, compared with patients >65 y, patients aged ≤65 y exhibited more chronic onset (p = 0.01) and longer disease duration (p = 0.01), more motor nerve involvements (p = 0.02), more amplitude involvement (p = 0.01), and higher rates of the inability to walk independently at presentation (p = 0.02). The present study construed that weakness and paresthesia are common symptoms in PNS with peripheral nerve damage in some areas, and the electrophysiological results mainly changed in amplitude. Tumor screening in young and middle-aged patients with peripheral neuropathy cannot be ignored.
关于伴有周围神经损伤的副肿瘤性神经综合征(PNS)的临床和电生理研究较少,这给临床识别和诊断带来了巨大挑战。我们分析了25例确诊为PNS且伴有周围神经损伤患者的临床和电生理数据。结果显示,最常见的主要症状是无力(20/25,80%),其次是麻木(13/25,52%)。19例患者(76%)在隐匿性肿瘤出现之前就表现出周围神经系统病变,从症状出现到肿瘤诊断的中位时间为4个月。电生理结果显示,与潜伏期或传导速度相比,波幅异常率更高,尤其是在感觉感觉神经筛查中不能忽视。 感觉神经方面。同时,我们发现,与65岁以上的患者相比,65岁及以下的患者发病更隐匿(p = 0.01)、病程更长(p = 0.01)、运动神经受累更多(p = 0.02)、波幅受累更多(p = 0.01),且就诊时无法独立行走的比例更高(p = 0.02)。本研究认为,无力和感觉异常是某些地区伴有周围神经损伤的PNS的常见症状,电生理结果主要在波幅方面发生变化。年轻和中年周围神经病变患者的肿瘤筛查不能被忽视。