de Freitas M R, Nascimento O J, de Freitas G R
Serviço de Neurologia, Faculdade de Medicina, Universidade Federal Fluminense, Niterói RJ, Brasil.
Arq Neuropsiquiatr. 1995 Sep;53(3-B):545-51. doi: 10.1590/s0004-282x1995000400001.
Charcot-Marie-Tooth (CMT) disease is the commonest inherited peripheral neuropathy. The clinical study of 45 patients with CMT is presented. They were derived from Antonio Pedro Hospital of Universidade Federal Fluminense in Niteroi, RJ, Brazil. Such patients could be divided by the motor conduction velocity in two types: a demyelinating form or type I (11 cases) and an axonal form or type II (34 cases). The disease was inherited as an autosomal dominant trait in 23 patients and as an autosomal recessive trait in 7 cases. In 15 patients the disorder was sporadic. The age of onset was in most of our cases before the 20 years. All of them had distal weakness in lower limbs. 38.2% had also distal weakness in upper limbs. 80% had distal wasting of the lower limbs and 50% had distal wasting of upper limbs. The tendon reflexes were absent in 64% in lower limbs and in 28% in upper limbs. The sensitive impairment in the distal regions of the extremities was mild in most patients. We found enlargement of peripheral nerves in 7 patients of type I. Pes cavus was present in 21 cases and scoliosis in 7. We found postural tremor of hands in 6 patients. In 9 cases there were rare features as mental retardation, trigeminal nevralgia, optic atrophy, deafness and calf enlargement. In most of our cases the clinical course was very slow progressive. A greater severity was seen in our sporadic cases.
夏科-马里-图斯(CMT)病是最常见的遗传性周围神经病。本文介绍了对45例CMT患者的临床研究。这些患者来自巴西里约热内卢尼泰罗伊市弗卢米嫩塞联邦大学安东尼奥·佩德罗医院。此类患者可根据运动传导速度分为两种类型:脱髓鞘型或I型(11例)和轴索性或II型(34例)。23例患者的疾病呈常染色体显性遗传,7例呈常染色体隐性遗传。15例患者的病症为散发性。在我们的大多数病例中,发病年龄在20岁之前。他们均有下肢远端无力症状。38.2%的患者上肢也有远端无力症状。80%的患者下肢有远端肌肉萎缩,50%的患者上肢有远端肌肉萎缩。64%的患者下肢腱反射消失,28%的患者上肢腱反射消失。大多数患者四肢远端区域的感觉障碍较轻。我们发现I型患者中有7例周围神经增粗。21例患者有高弓足,7例有脊柱侧弯。我们发现6例患者有手部姿势性震颤。9例患者有智力发育迟缓、三叉神经痛、视神经萎缩、耳聋和小腿增粗等罕见症状。在我们的大多数病例中,临床病程进展非常缓慢。散发性病例的病情更为严重。