[Clinical characteristics of the peripheral form of epidemic neuropathy in the province of Cienfuegos].

INTRODUCTION

From October 1992 to September 1993 clinical observations of the civil population of Cienfuegos revealed the presence of epidemic neuropathy (EN) reaching about 2,000 patients. The clinical manifestations were not uniform. Although numerous studies have been carried out in our country, none have established the characteristics of EN 'the peripheral form'.

MATERIAL AND METHODS

We studied the first 50 patients assisted by the neurological services of the clinical surgical hospital Dr. Gustavo Aldereguia Lima of Cienfuegos diagnosed of EN 'peripheral form' according to the procedure established by Ministry of Public Health of Cuba. A clinical history was made for each patient consisting of: General data, history of toxic, nutritional, malabsorption factors and chronic illnesses; symptoms and a neurological examinations. Laboratory test, in a group of patients, were done in sera, urine, cerebrospinal fluid (CSF), gastric juice and neurophysiological studies that included computerized evoked potentials and electroencephalograms registers.

RESULTS

Upon analysis of the clinical history, nutritional factors was common to all the patients associated to toxic and malabsorption. The clinical forms were neuropathy (NP) 48%, myeloneuropathy (MNP) 42% and myelopathy (MP) 10%. Retrobulbar optic neuropathy was observed in 42% of the patients and auditory neuropathy in 22%.

CONCLUSIONS

The clinical characteristics of NP, in our cases, indicated that this disease fundamentally affects the sensorial neurons and the sensitive peripheral nerves, bilaterally, symmetrically, distally and predominantly in lower limbs. The pathological process has been associated with a distal axonopathy. However, clinic signs of myelopathy can be found up to 40% frequently combined with neuropathy or in isolated form, and seems to affect the posterior and lateral columns of the spinal cord, mainly at thoraciclumbar level. Neuropathy of central nervous system is unknown since no patient has died of EN.