Notermans N C, van Doorn P A
Afd. Neurologie, Academisch Ziekenhuis, Utrecht.
Ned Tijdschr Geneeskd. 1997 Nov 29;141(48):2327-33.
A polyneuropathy is characterized by a symmetrical distribution of sensory or motor abnormalities, more pronounced distally than proximally and usually more evident in the lower than in the upper limbs. Polyneuropathies may be classified on the basis of (a) clinical picture: acute/subacute/chronic, sensory/motor/autonomous, axonal degeneration/segmental demyelinization, and (b) cause: metabolic disorder, deficiency, infection, auto(dys)immunity, hereditary and toxic/iatrogenic polyneuropathy, with idiopathic polyneuropathy as the remaining group. Damaged nerves may recover as the result of spontaneous remyelinization and axonal regeneration. Treatment is particularly successful in immunomediated neuropathies. Withdrawal is often successful in intoxications and suppletion in deficiencies. Even if no treatment is possible, the diagnosis is important: the patient can be taught to accept his disease and the prognosis can be determined, in connection with possible handicaps.
多发性神经病的特征是感觉或运动异常呈对称性分布，远端比近端更明显，通常在下肢比在上肢更显著。多发性神经病可根据以下方面进行分类：(a) 临床表现：急性/亚急性/慢性、感觉性/运动性/自主性、轴索性变性/节段性脱髓鞘；(b) 病因：代谢紊乱、缺乏、感染、自身（功能）免疫、遗传性以及中毒性/医源性多发性神经病，特发性多发性神经病为其余类型。受损神经可通过自发的髓鞘再生和轴突再生而恢复。免疫介导性神经病的治疗尤为成功。在中毒情况下停药往往有效，在缺乏症时补充相应物质也有效。即使无法进行治疗，诊断也很重要：可以教导患者接受其疾病，并结合可能出现的残疾情况确定预后。
