Simmons Z, Wald J J, Albers J W
Division of Neurology, The Pennsylvania State University College of Medicine, Hershey Medical Center, 17033, USA.
Muscle Nerve. 1997 Dec;20(12):1569-75. doi: 10.1002/(sici)1097-4598(199712)20:12<1569::aid-mus12>3.0.co;2-w.
We previously reviewed the presentation, initial clinical course, and electrodiagnostic features of children with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). We now report the long-term follow-up of 12 children with idiopathic CIDP, and compare these to 62 adults with idiopathic CIDP. Children often had more rapidly fluctuating courses than adults. A relapsing course was significantly more common in children than in adults. The recovery of children from each episode of deterioration was usually excellent, and better, on average, than in adults. Ventilatory support was never required for children with slowly evolving illness; only 2 children with a precipitous onset clinically resembling Guillain-Barré syndrome required ventilatory support. Prednisone, plasma exchange, and intravenous immunoglobulin (IVIg) usually were effective in children. Multiple courses of IVIg could be given with continued efficacy. Treatment often could be discontinued in children with relapsing courses. The prognosis for children was excellent. Adults demonstrated a good, but more variable, outcome.
我们之前回顾了慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)患儿的临床表现、初始病程及电诊断特征。我们现在报告12例特发性CIDP患儿的长期随访情况,并将其与62例特发性CIDP成人患者进行比较。儿童的病程通常比成人波动更快。复发型病程在儿童中明显比成人更常见。儿童每次病情恶化后的恢复通常很好,平均而言比成人更好。病情缓慢进展的儿童从未需要通气支持;只有2例临床上起病急骤、类似吉兰 - 巴雷综合征的儿童需要通气支持。泼尼松、血浆置换和静脉注射免疫球蛋白(IVIg)通常对儿童有效。多次给予IVIg仍有持续疗效。复发型病程的儿童通常可以停药。儿童的预后极佳。成人的预后良好,但更具变异性。