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[慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)患者神经传导的快速改善]

[Rapid improvement of nerve conduction in a patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)].

作者信息

Saito Y, Yokota T

机构信息

Department of Neurology, Tokyo Medical and Dental University.

出版信息

Rinsho Shinkeigaku. 1993 Oct;33(10):1066-9.

PMID:8293607
Abstract

A patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) underwent electrophysiological examinations before and three days after high-dose intravenous gamma-globulin therapy. In only three days, the distal latency and MCV of the right median nerve were markedly improved without change of amplitude or configuration of CMAP. Such rapid improvement in conduction velocity might not be due to remyelination, because it occurred in only three days. During recovery from conduction block after lidocaine administration in normal subjects, the distal latency was shortened without the change of its amplitude and configuration. This phenomenon is similar to the improvement in the distal latency of the right median nerve of this patient after high-dose intravenous gamma-globulin therapy. We assume, therefore, that the conduction slowing in CIDP should be attributed to inactivation of sodium channels as well as demyelination.

摘要

一名慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)患者在大剂量静脉注射γ-球蛋白治疗前及治疗后三天接受了电生理检查。仅在三天内,右侧正中神经的远端潜伏期和运动神经传导速度(MCV)就有显著改善,而复合肌肉动作电位(CMAP)的波幅或波形未发生变化。传导速度如此迅速的改善可能并非由于髓鞘再生,因为这仅在三天内就发生了。在正常受试者给予利多卡因后从传导阻滞恢复过程中,远端潜伏期缩短,但其波幅和波形未改变。这种现象与该患者大剂量静脉注射γ-球蛋白治疗后右侧正中神经远端潜伏期的改善相似。因此,我们推测,CIDP中的传导减慢应归因于钠通道失活以及脱髓鞘。

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