Poza J J, Cobo A M, Martí-Massó J F
Servicio de Neurología, Hospital Nuestra Señora de Aránzazu, San Sebastián.
Neurologia. 1996 Oct;11(8):276-9.
The aim of this study was to determine the frequency and characteristics of peripheral neuropathy associated to polycythemia vera. A prospective clinical and electrophysiological study was performed of 28 patients with polycythemia vera. Other causes of neuropathy were excluded. Eleven patients experienced paresthesiae, which were usually mild. In 13 (46%) patients, clinical examination revealed features suggesting polyneuropathy. Nerve conduction indexes were abnormal in 20 (71%) patients, suggesting the presence of a predominantly sensory axonal polyneuropathy. In the somatosensory evoked potentials a delay of the P40 wave was seen in 17 patients, while 11 exhibited a delay of the N20 wave. Three of these patients also showed bilateral increases in the I-III, I-V and III-V intervals of brain-stem evoked potentials. In most cases, the delay was moderate and symmetrical. No differences in sex, age, duration of disease, hematocrit values, or platelet counts were found between patients with or without clinical or electrophysiological polyneuropathy. A high percentage of patients with polycythemia vera present clinical or electrophysiological signs of predominantly sensory axonal polyneuropathy which is probably secondary to ischemia, due to increased blood viscosity and platelet dysfunction.
本研究的目的是确定与真性红细胞增多症相关的周围神经病变的发生率及特征。对28例真性红细胞增多症患者进行了一项前瞻性临床和电生理研究。排除了其他神经病变的病因。11例患者出现感觉异常，通常较轻微。13例（46%）患者的临床检查发现提示多发性神经病变的特征。20例（71%）患者的神经传导指标异常，提示存在以感觉轴索性为主的多发性神经病变。在体感诱发电位中，17例患者出现P40波延迟，11例出现N20波延迟。其中3例患者还表现出脑干诱发电位I-III、I-V和III-V间期双侧延长。在大多数情况下，延迟为中度且对称。有或无临床或电生理多发性神经病变的患者在性别、年龄、病程、血细胞比容值或血小板计数方面均未发现差异。真性红细胞增多症患者中很大一部分存在以感觉轴索性为主的多发性神经病变的临床或电生理体征，这可能继发于缺血，原因是血液粘度增加和血小板功能障碍。
