Bradley W G, Verma A
Department of Neurology, University of Miami School of Medicine, FL 33136, USA.
Neurology. 1996 Dec;47(6):1446-51. doi: 10.1212/wnl.47.6.1446.
Painful distal sensory polyneuropathy (DSP) is the most common peripheral neuropathy in patients with human immunodeficiency virus-1 (HIV-1) infection. There is no specific therapy for DSP, and nonspecific treatment with pain blockers and narcotic agents generally fails to adequately control the symptoms. We report two patients who had subacute painful neuropathy in the B2 (formerly AIDS-related complex [ARC]) stage of HIV-1 infection. Neurophysiologic studies revealed predominantly axonal sensorimotor neuropathy. Sural nerve biopsy in both cases showed a necrotizing vasculitis. Treatment with corticosteroids resulted in rapid relief of pain, followed by arrest of the neuropathic process. Although not previously emphasized, vasculitic neuropathy must be considered among the treatable causes of painful sensory neuropathy in HIV-1-infected individuals.
疼痛性远端感觉性多发性神经病（DSP）是人类免疫缺陷病毒1型（HIV-1）感染患者中最常见的周围神经病。目前尚无针对DSP的特异性治疗方法，使用止痛剂和麻醉剂进行的非特异性治疗通常无法充分控制症状。我们报告了两名在HIV-1感染的B2期（以前称为艾滋病相关综合征[ARC]）出现亚急性疼痛性神经病的患者。神经生理学研究显示主要为轴索性感觉运动神经病。两例患者的腓肠神经活检均显示坏死性血管炎。使用皮质类固醇治疗后疼痛迅速缓解，随后神经病变进程停止。尽管以前未被强调，但在HIV-1感染个体中，血管炎性神经病必须被视为疼痛性感觉神经病的可治疗病因之一。
