Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.
Neuromuscular Division, Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.
Handb Clin Neurol. 2023;195:587-608. doi: 10.1016/B978-0-323-98818-6.00004-2.
The autoimmune peripheral neuropathies with prominent motor manifestations are a diverse collection of unusual peripheral neuropathies that are appreciated in vast clinical settings. This chapter highlights the most common immune-mediated, motor predominant neuropathies excluding acute, and chronic inflammatory demyelinating polyradiculoneuropathy (AIDP and CIDP, respectively). Other acquired demyelinating neuropathies such as distal CIDP and multifocal motor neuropathy will be covered. Additionally, the radiculoplexus neuropathies, resulting from microvasculitis-induced injury to nerve roots, plexuses, and nerves, including diabetic and nondiabetic lumbosacral radiculoplexus neuropathy and neuralgic amyotrophy (i.e., Parsonage-Turner syndrome), will be included. Finally, the motor predominant peripheral neuropathies encountered in association with rheumatological disease, particularly Sjögren's syndrome and rheumatoid arthritis, are covered. Early recognition of these distinct motor predominant autoimmune neuropathies and initiation of immunomodulatory and immunosuppressant treatment likely result in improved outcomes.
以运动表现为主的自身免疫性周围神经病是一组不同的不常见周围神经病，在广泛的临床环境中得到认可。本章重点介绍最常见的免疫介导、以运动为主的神经病，不包括急性和慢性炎症性脱髓鞘性多发性神经根神经病（分别为 AIDP 和 CIDP）。其他获得性脱髓鞘神经病，如远端 CIDP 和多灶性运动神经病也将涵盖在内。此外，还包括神经根、神经丛和神经因微血管炎损伤引起的脊神经根神经病，包括糖尿病和非糖尿病腰骶神经根神经病和神经痛性肌萎缩（即，Parsonage-Turner 综合征）。最后，还包括与风湿性疾病相关的以运动表现为主的周围神经病，特别是干燥综合征和类风湿关节炎。早期识别这些不同的以运动表现为主的自身免疫性神经病，并开始免疫调节和免疫抑制治疗，可能会改善预后。
