Feldmeyer J J, Schneider C
Electrodiagn Ther. 1980;17(1):15-31.
The clinical and EMG aspects of a particular form of polyneuropathy encountered in seven young alcoholics are presented. This form is characterized by an acute, severe and extensive paralysis with motor, sensitive and vegetative deficit. The reasons of the sudden aggravation of a previous chronic PN are thiamine deficiency -- wich realise the BERI-BERI with Wernicke-Korsakoff encephalopathy -- and a probable poisoning due to the multiples toxics included in the alcoholised beverages. The remarkable clinical features of this PN are: the quickness of the onset, the extension and the severity of the paralysis, the young age of the patients and the relative prevalence of the women -- these two points suggesting a possible congenital predisposition -- and the fast improvement under vitamino-therapy and abstinence. Our EMG findings, in accord with some recent electro-physiological studies with histological confrontations, show up the indirect signs of a massive axonal degeneration in contrast to a mild demyelination. The EMG examen was a good contribution to exclude other possibilities like Guillain-Barré syndrome or alcoholic myopathy, and to follow the evolution.
本文介绍了在七名年轻酗酒者中遇到的一种特殊形式的多发性神经病的临床和肌电图表现。这种形式的特点是急性、严重且广泛的瘫痪,伴有运动、感觉和自主神经功能障碍。先前慢性多发性神经病突然加重的原因是硫胺素缺乏(导致脚气病伴韦尼克-科尔萨科夫脑病)以及酒精饮料中所含多种毒素可能引起的中毒。这种多发性神经病的显著临床特征包括:起病迅速、瘫痪范围广且严重、患者年龄较轻以及女性相对患病率较高(这两点提示可能存在先天性易感性),以及在维生素治疗和戒酒情况下快速好转。我们的肌电图检查结果与近期一些结合组织学对比的电生理研究一致,显示出大量轴索变性的间接征象,与轻度脱髓鞘形成对比。肌电图检查有助于排除格林-巴利综合征或酒精性肌病等其他可能性,并跟踪病情进展。