Emeryk-Szajewska B, Badurska B, Kostera-Pruszczyk A
Department of Neurology, Warsaw Medical School, Poland.
Electromyogr Clin Neurophysiol. 1998 Mar;38(2):95-101.
We performed clinical and electrophysiological studies in 42 children with hereditary motor and sensory neuropathy type I and II (HMSN I and HMSN II) and in 103 members of their families. In 24 families with HMSN I the conduction velocity and the latency were markedly changed in the nerves innervating the distal muscles (median, peroneal nerves), as well as proximal muscles (facial, axillary, and musculocutaneous nerves). The changes were uniform in all motor and sensory nerves studied in the particular patient. No nerve conduction worsening with age has been found in cross-sectional analysis. In patients with HMSN I the conduction velocity was impaired even when the clinical abnormalities were minimal. The degree of the conduction velocity slowing was uniform within majority of the families. Homogeneity of conduction velocity slowing in individuals with HMSN I regardless of clinical expression suggests a primary myelin defect as an underlying cause. In patients from 18 families with HMSN II slight changes in conduction velocity were found only in the nerves innervating the distal muscles, the latency of axillary and facial nerves was within normal range. We recommend examining conduction time in facial and axillary nerves as a useful procedure for differentiation between HMSN I and II, especially in families with borderline conduction values in the long nerves.
我们对42例遗传性运动和感觉神经病I型和II型(HMSN I和HMSN II)患儿及其103名家庭成员进行了临床和电生理研究。在24个患有HMSN I的家庭中,支配远端肌肉(正中神经、腓总神经)以及近端肌肉(面神经、腋神经和肌皮神经)的神经传导速度和潜伏期显著改变。在特定患者中,所有研究的运动和感觉神经的变化都是一致的。横断面分析未发现神经传导随年龄恶化。在HMSN I患者中,即使临床异常很轻微,传导速度也会受损。大多数家庭中传导速度减慢的程度是一致的。HMSN I患者无论临床表现如何,传导速度减慢的同质性表明原发性髓鞘缺陷是潜在原因。在18个患有HMSN II的家庭的患者中,仅在支配远端肌肉的神经中发现传导速度有轻微变化,腋神经和面神经的潜伏期在正常范围内。我们建议检查面神经和腋神经的传导时间,作为区分HMSN I和II的有用方法,特别是在长神经传导值处于临界值的家庭中。