Freitas M R, Nascimento O J, Chimelli L, de Freitas G R
Serviço de Neurologia, Hospital Universitário Antônio Pedro, Brasil.
Arq Neuropsiquiatr. 1995 Sep;53(3-B):560-9.
We studied the pathological findings of sural nerve biopsy in 41 patients with Charcot-Marie-Tooth (CMT) disease. They were previously classified by the median motor conduction velocity (MCV) in two types. Type I (demyelinating) with 9 patients and type II (axonal) with 32 cases. In type I we found loss of myelinated fibers (unimodal histogram), demyelinated and remyelinated axons with numerous onion bulb formations. In one case there was thickness of myelin with thin axons (axonal atrophy). In type II there were seven patients with normal sural nerve biopsy. In 25 cases there were mild to severe loss of myelinated fibers. In 5 patients the number of myelinated fibers was increased due to the great regeneration of the axons. The electron microscopic studies in type II showed in a few cases small onion bulbs and in one case axonal atrophy. In type I there was no correlation between clinical severity and the loss of myelinated fibers, but there was relationship between the low MCV and the intensity of myelinated fibers. In type II we did not found any correlation between clinical course, MCV and pathological findings.
我们研究了41例夏科-马里-图斯(CMT)病患者腓肠神经活检的病理结果。他们之前根据正中运动传导速度(MCV)分为两种类型。I型(脱髓鞘型)9例,II型(轴索性)32例。在I型中,我们发现有髓纤维丢失(单峰直方图)、脱髓鞘和再髓鞘化的轴突以及大量洋葱球样结构形成。1例存在髓鞘增厚伴轴突变细(轴突萎缩)。在II型中,7例患者腓肠神经活检正常。25例有轻至重度有髓纤维丢失。5例患者有髓纤维数量因轴突大量再生而增加。II型的电子显微镜研究显示,少数病例有小洋葱球样结构,1例有轴突萎缩。在I型中,临床严重程度与有髓纤维丢失之间无相关性,但MCV降低与有髓纤维的减少程度有关。在II型中,我们未发现临床病程、MCV与病理结果之间存在任何相关性。