Nukada H, Pollock M
J Neurol Sci. 1981 Jul;51(1):51-67. doi: 10.1016/0022-510x(81)90059-9.
This report describes peripheral nerve morphology in 3 patients whose acute polyneuropathy followed disulfiram therapy. In all patients a combination of axonal degeneration with segmental demyelination and remyelination was seen, suggesting a varying degree of toxicity to both cytons and Schwann cells. The observed randomness of abnormal internodes argued against primary axonal atrophy and secondary demyelination. While large myelinated fibres were preferentially lost, ultrastructural studies also suggested degeneration of unmyelinated fibres. Because of high chloral consumption at the onset of peripheral nerve disease in 2 patients, the possibility of disulfiram-chloral interaction was considered. Present evidence suggests that the combined use of chloral or its derivatives with disulfiram is best avoided.
本报告描述了3例急性多发性神经病发生于双硫仑治疗后的患者的周围神经形态。在所有患者中均可见轴突变性与节段性脱髓鞘及髓鞘再生并存，提示对神经元胞体和施万细胞均有不同程度的毒性。观察到的异常节段的随机性排除了原发性轴索萎缩和继发性脱髓鞘。虽然大的有髓纤维优先丢失，但超微结构研究也提示无髓纤维变性。由于2例患者在周围神经疾病发作时大量使用水合氯醛，因此考虑了双硫仑与水合氯醛相互作用的可能性。目前的证据表明，最好避免水合氯醛或其衍生物与双硫仑联合使用。
