Chen Limin, Zhang Hongbo, Li Chunnv, Yang Nuo, Wang Jiangtao, Liang Jianmin
Department of Pediatric Neurology, Children's Medical Center, The First Hospital of Jilin University, Changchun, 130021, China.
Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, 130021, China.
J Neurol. 2024 Dec 12;272(1):41. doi: 10.1007/s00415-024-12839-7.
This review summarizes the clinical and electromyography (EMG) characteristics and peripheral myelin protein 22 (PMP22) gene-related diseases of hereditary neuropathy with liability to pressure palsies (HNPP). Clinical, EMG, and laboratory data of patients diagnosed with HNPP at our institution from 2022 to 2023 were retrospectively reviewed. Relevant literature from January 2003 to June 2024 was retrieved from PubMed using the keywords "hereditary neuropathy with liability to pressure palsies" and "HNPP." Clinical manifestations, EMG characteristics, and gene detection results of HNPP were summarized. All patients exhibited transient neurological symptoms and tested positive for the PMP22 deletion. EMG revealed multiple peripheral nerve abnormalities. Sixty-eight studies meeting the inclusion and exclusion criteria were included, comprising 124 HNPP cases (including six from our study), with 67 males and 57 females. The mean age of onset and diagnosis for the 124 cases were 26.5 ± 18 years and 32.7 ± 18.9 years, respectively, with a maximum onset-to-diagnosis interval of 40 years. Typical weakness and numbness in vulnerable areas were observed in 63.7% of cases, with 62% experiencing recurrent episodes. Atypical symptoms were present in 29.8%, while 6.5% were asymptomatic. Patients exhibited pain and muscular dystrophy (17.7%), pes cavus (12.1%), and a family history of HNPP (64.5%). Among symptomatic patients, triggers were traction or compression (57.8%), temperature changes (3.4%), or unclear (38.8%). Heterozygous PMP22 deletions and other PMP22 gene mutations were found in 77.4% and 22.6% of cases, respectively.
本综述总结了遗传性压力易感性周围神经病(HNPP)的临床和肌电图(EMG)特征以及外周髓鞘蛋白22(PMP22)基因相关疾病。对2022年至2023年在我院诊断为HNPP的患者的临床、EMG和实验室数据进行了回顾性分析。使用关键词“遗传性压力易感性周围神经病”和“HNPP”从PubMed检索了2003年1月至2024年6月的相关文献。总结了HNPP的临床表现、EMG特征和基因检测结果。所有患者均表现出短暂性神经症状,且PMP22缺失检测呈阳性。EMG显示多条周围神经异常。纳入了68项符合纳入和排除标准的研究,包括124例HNPP病例(包括我们研究中的6例),其中男性67例,女性57例。124例病例的平均发病年龄和诊断年龄分别为26.5±18岁和32.7±18.9岁,发病至诊断的最长间隔为40年。63.7%的病例在易损部位出现典型的无力和麻木,62%的病例有复发发作。29.8%的病例有非典型症状,6.5%的病例无症状。患者表现出疼痛和肌肉萎缩(17.7%)、高弓足(12.1%)以及HNPP家族史(64.5%)。在有症状的患者中,诱发因素为牵引或压迫(57.8%)、温度变化(3.4%)或不明原因(38.8%)。分别在77.4%和22.6%的病例中发现了杂合性PMP22缺失和其他PMP22基因突变。