Gupta B K, Kochar D K
Department of Medicine, S.P. Medical College, Bikaner, India.
Int J Lepr Other Mycobact Dis. 1994 Dec;62(4):586-93.
The present study was conducted in 25 leprosy patients (of different age and sex) with or without clinical evidence of neuropathy. The diagnosis was confirmed by skin biopsy. A group of 15 age- and sex-matched, healthy persons also were studied for comparison and served as controls. Motor nerve conduction velocity (MNCV) was reduced in nine patients (36%) and sensory nerve conduction velocity (SNCV) was reduced in three patients (12%). Late responses (H-reflex and F-wave) were deranged in 16 patients (64%). Somatosensory evoked potential (SSEP) was deranged in 13 patients (52%). N7-N18 interpeak latency (PCT) was prolonged in two patients (8%); none showed prolongation of N18-N35 interpeak latency (CCT). We observed that nerve conduction velocity, late responses, and SSEPs were deranged in all types of leprosy, regardless of clinical evidence of neuropathy, and were more prominently affected in the tuberculoid (TT) type of leprosy. A study of late responses is more informative than conventional nerve conduction studies for the detection of early lesions of the nerves. The study of SSEP shows involvement of the peripheral part of the nervous system and complete sparing of the central part of the nervous system.
本研究纳入了25例麻风病患者(不同年龄和性别),这些患者有或无神经病变的临床证据。诊断通过皮肤活检得以证实。还研究了一组15名年龄和性别匹配的健康人作为对照。9例患者(36%)运动神经传导速度(MNCV)降低,3例患者(12%)感觉神经传导速度(SNCV)降低。16例患者(64%)的迟发反应(H反射和F波)紊乱。13例患者(52%)体感诱发电位(SSEP)紊乱。2例患者(8%)N7 - N18峰间潜伏期(PCT)延长;无人显示N18 - N35峰间潜伏期(CCT)延长。我们观察到,无论有无神经病变的临床证据,所有类型的麻风病患者神经传导速度、迟发反应和SSEP均紊乱,且在结核样型(TT)麻风病中受影响更显著。对于检测早期神经病变,迟发反应的研究比传统神经传导研究更具信息价值。SSEP研究显示神经系统外周部分受累,而中枢部分完全未受累。