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[电生理研究中的遗传性感觉运动神经病]

[Hereditary sensorimotor neuropathy in electrophysiological studies].

作者信息

Emeryk-Szajewska B, Badurska B, Kostera-Pruszczyk A

机构信息

Kliniki Neurologicznej AM, Warszawie.

出版信息

Neurol Neurochir Pol. 1998 Mar-Apr;32(2):295-308.

PMID:9760549
Abstract

We performed clinical and electrophysiological studies in 42 children with hereditary motor and sensory neuropathy type I and II (HMSN I and II) and in 103 members of their families. In 24 families with HMSN I the conduction velocity and 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 a particular patient. The intensity of changes was similar in members of their families even when the clinical abnormalities were minimal, thus the degree of conduction velocity slowing was uniform within families. In adults with HMSN I (group A i B) we found less marked slowing of nerve conduction as compared to children (group P), the difference being significant (p < 0.001). It may suggest a slow process of peripheral nerves maturation despite the existing morbid condition. In patients of 18 families with HMSN II slight changes in conduction velocity were found only in nerves innervating the distal muscles, more evident in legs (peroneal and sural nerves). Conduction time of facial, axillary and musculo-cutaneous nerves was normal. The values of nerve conduction were not changing with patients' age. We recommend examining conduction time in facial, axillary or musculocutaneous nerve as a useful procedure for differentiation between HMSN I and II, especially in families with borderline conduction values in the nerves innervating distal muscles.

摘要

我们对42例遗传性运动和感觉神经病I型和II型(HMSN I和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,支配远端肌肉的神经(正中神经、腓总神经)以及近端肌肉的神经(面神经、腋神经和肌皮神经)的传导速度和潜伏期均有明显改变。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。即使临床异常很轻微,其家庭成员的变化强度也相似,因此家庭内部传导速度减慢的程度是一致的。在患有HMSN I的成人(A组和B组)中,我们发现与儿童(P组)相比,神经传导减慢不那么明显,差异有统计学意义(p<0.001)。这可能表明尽管存在病态情况,但周围神经成熟过程缓慢。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,在腿部(腓总神经和腓肠神经)更明显。面神经、腋神经和肌皮神经的传导时间正常。神经传导值不随患者年龄变化。我们建议检查面神经、腋神经或肌皮神经的传导时间,这是区分HMSN I和II的有用方法,尤其是在支配远端肌肉的神经传导值处于临界值的家庭中。

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