De León Andrés M, Garcia-Santibanez Rocio, Harrison Taylor B
Neuromuscular Division Department of Neurology, Emory University, Executive Park 12 NE, GA 30329 Atlanta, USA.
Division of Neuromuscular Medicine, Department of Neurology, Emory University School of Medicine, 83 Jessie Junior Drive Box 039, Atlanta, GA 30303 USA.
Curr Treat Options Neurol. 2023 Jun 10:1-17. doi: 10.1007/s11940-023-00756-5.
The aim of this review is to discuss the presentation, diagnosis, and management of polyneuropathy (PN) in selected infections. Overall, most infection related PNs are an indirect consequence of immune activation rather than a direct result of peripheral nerve infection, Schwann cell infection, or toxin production, though note this review will describe infections that cause PN through all these mechanisms. Rather than dividing them by each infectious agent separately, we have grouped the infectious neuropathies according to their presenting phenotype, to serve as a guide to clinicians. Finally, toxic neuropathies related to antimicrobials are briefly summarized.
While PN from many infections is decreasing, increasing evidence links infections to variants of GBS. Incidence of neuropathies secondary to use of HIV therapy has decreased over the last few years.
In this manuscript, a general overview of the more common infectious causes of PN will be discussed, dividing them across clinical phenotypes: large- and small-fiber polyneuropathy, Guillain-Barré syndrome (GBS), mononeuritis multiplex, and autonomic neuropathy. Rare but important infectious causes are also discussed.
本综述旨在探讨特定感染中多发性神经病（PN）的临床表现、诊断及管理。总体而言，大多数感染相关的PN是免疫激活的间接后果，而非周围神经感染、施万细胞感染或毒素产生的直接结果，不过本综述将描述通过所有这些机制导致PN的感染。我们并非按每种感染因子分别进行分类，而是根据其呈现的表型对感染性神经病进行了分组，以为临床医生提供指导。最后，简要总结了与抗菌药物相关的中毒性神经病。
虽然许多感染所致的PN有所减少，但越来越多的证据表明感染与格林-巴利综合征（GBS）的变异型有关。在过去几年中，因使用抗逆转录病毒疗法继发的神经病发病率有所下降。
在本手稿中，将讨论PN较常见的感染病因的总体概况，按临床表型进行分类：大纤维和小纤维多发性神经病、格林-巴利综合征（GBS）、多发性单神经炎及自主神经病。还将讨论罕见但重要的感染病因。
