慢性获得性脱髓鞘性多发性神经病17系列.docx
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慢性获得性脱髓鞘性多发性神经病17系列.docx
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慢性获得性脱髓鞘性多发性神经病17系列
Chronicacquireddemyelinatingmultipleneuropathy
1.CurrNeurolNeurosciRep.2014Oct;14(10):
487.doi:
10.1007/s11910-014-0487-z.
Neurologicmanifestationsofgastrointestinalandliverdiseases.
FerroJM
(1),OliveiraS.
Authorinformation:
(1)DepartmentofNeurosciences,ServiceofNeurology,HospitaldeSantaMaria,
UniversityofLisbon,Av.Prof.EgasMoniz,1649-035,Lisboa,Portugal,
jmferro@fm.ul.pt.
Hepaticandgastrointestinaldisorderscanproduceawidespectrumofneurologic
complicationsbothaffectingthecentralnervoussystem(CNS)andtheperipheral
nervoussystem.Thesemanifestationsrangeinseverityfromcomainacuteliver
failureandacutepancreatitis,tominorcognitivechangesinchronic
portosystemicencephalopathyandhepatitisC.Cerebrovasculardiseasescan
complicatehepatitisCinfectionandinflammatoryboweldisease.Demyelinating
disordersmayco-existwithinflammatoryboweldisease.Anti-tumornecrosis
factoralphadrugsmayinducedemyelination.Ataxiamayoccurinmalabsorption
syndromesandinglutenrelateddisorders.Characteristicmovementdisordersare
keyfeaturesofacquiredhepatocerebraldegenerationandofWhippledisease.
Multipletypesofneuropathycanbefoundinassociationwithhepatitis,
inflammatoryboweldiseaseandglutenrelateddisorders.
PMID:
25171900[PubMed-indexedforMEDLINE]
2.NeuroimagingClinNAm.2013May;23
(2):
321-36.doi:
10.1016/j.nic.2012.12.010.
Epub2013Jan23.
Mimicsandrarepresentationsofpediatricdemyelination.
O'MahonyJ
(1),ShroffM,BanwellB.
Authorinformation:
(1)DivisonofNeurology,DepartmentofPediatrics,ResearchInstitute,The
HospitalforSickChildren,Toronto,Ontario,Canada.
Thisarticlereviewsthefeaturesthatshouldpromptconsiderationofdiseases
thatmimicacquireddemyelinatingsyndromesandmultiplesclerosisusing
vignettestohighlightunusualclinicalandradiologicfeatures.Casesof
transversemyelitis,spinalinfarction,acutedisseminatedencephalomyelitis,
fever-inducedrefractoryepilepticencephalopathyinschool-agedchildren,
small-vesselvasculitis,Griscellisyndrometype2,cysticercosis,vitaminB12
deficiency,andchronicrelapsinginflammatoryopticneuropathyarepresented.
CrownCopyright©2013.PublishedbyElsevierInc.Allrightsreserved.
PMID:
23608693[PubMed-indexedforMEDLINE]
3.MuscleNerve.2013Feb;47
(2):
292-6.doi:
10.1002/mus.23629.Epub2012Nov21.
Distalacquireddemyelinatingsymmetricpolyneuropathyprogressingtoclassic
chronicinflammatorydemyelinatingpolyneuropathyandresponsetofludarabineand
cyclophosphamide.
LeitchMM
(1),ShermanWH,BrannaganTH3rd.
Authorinformation:
(1)DepartmentofNeurology,NeurologicalInstitute,ColumbiaUniversity,710W
168thStreet,Box163,NewYork,NewYork10032USA.
INTRODUCTION:
Distalacquireddemyelinatingsymmetricpolyneuropathy(DADS)is
proposedasadistinctentityfromclassicchronicinflammatorydemyelinating
polyneuropathy(CIDP).
METHODS:
Wereporta58-year-oldwomanwithDADSthatprogressedtoaseverecase
ofclassicCIDP.
RESULTS:
Shehaddistalnumbnessandparesthesias,minimaldistalweaknessand
impairedvibratorysensation.Shehadanti-MAGantibodies,negativeWesternblot,
andlackedamonoclonalgammopathy.Therewereprolongeddistalmotorlatencies.
Sheremainedstablefor6yearsuntildevelopingproximalanddistalweakness.
Nerveconductionstudiesshowedmultipleconductionblocks.Shedeveloped
quadriparesisdespitefirst-linetreatmentforCIDP.Shewasstartedon
cyclophosphamideandfludarabine.Twenty-fivemonthsafterreceiving
chemotherapy,shehadonlymildsignsofneuropathyoffallimmunotherapy.
CONCLUSIONS:
DADSmayprogresstoclassicCIDPandisunlikelytobeaseparate
disorder.FludarabineandcyclophosphamidemaybeeffectiveforrefractoryCIDP.
Copyright©2012WileyPeriodicals,Inc.
PMID:
23168526[PubMed-indexedforMEDLINE]
4.SeminNeurol.2012Jul;32(3):
187-95.doi:
10.1055/s-0032-1329194.Epub2012Nov
1.
Chronicinflammatorydemyelinatingpolyradiculoneuropathy:
frombenchtobedside.
PeltierAC
(1),DonofrioPD.
Authorinformation:
(1)DepartmentofNeurology,VanderbiltMedicalCenter,MedicalCenterNorth,
Nashville,Tennessee37232-2551,USA.amanda_c_peltier@vanderbilt.edu
Chronicinflammatorydemyelinatingpolyradiculoneuropathy(CIDP)isthemost
commontreatablechronicautoimmuneneuropathy.Multiplediagnosticcriteriahave
beenestablished,withtheprimarygoalofidentifyingneurophysiologichallmarks
ofacquireddemyelination.Treatmentmodalitieshaveexpandedtoincludenumerous
immunomodulatorytherapies,althoughthebestevidencecontinuestobefor
corticosteroids,plasmaexchange,andintravenousimmunoglobulin(IVIg).This
reviewdescribesthepathology,epidemiology,pathogenesis,diagnosis,and
treatmentofCIDP.
ThiemeMedicalPublishers333SeventhAvenue,NewYork,NY10001,USA.
PMID:
23117943[PubMed-indexedforMEDLINE]
5.AnnIndianAcadNeurol.2011Apr;14
(2):
81-92.doi:
10.4103/0972-2327.82789.
Chronicdysimmuneneuropathies:
Beyondchronicdemyelinating
polyradiculoneuropathy.
KhadilkarSV
(1),DeshmukhSS,DhondePD.
Authorinformation:
(1)DepartmentofNeurology,GrantMedicalCollegeandSirJJGroupofHospitals,
Mumbai,India.
Thespectrumofchronicdysimmuneneuropathieshaswidenedwellbeyondchronic
demyelinatingpolyradiculoneuropathy(CIDP).Puremotor(multifocalmotor
neuropathy),sensorimotorwithasymmetricalinvolvement(multifocalacquired
demylinatingsensoryandmotorneuropathy),exclusivelydistalsensory(distal
acquireddemyelinatingsensoryneuropathy)andveryproximalsensory(chronic
immunesensorypolyradiculopathy)constitutethevariantsofCIDP.Correct
diagnosisoftheseentitiesisofimportanceintermsofinitiationof
appropriatetherapyaswellasprognosticationofthesepatients.Theratesof
detectionofimmune-mediatedneuropathieswithmonoclonalcellproliferation
(monoclonalgammopathyofunknownsignificance,multiplemyeloma,etc.)havebeen
facilitatedasbetterdiagnostictoolssuchasserumimmunofixation
electrophoresisarebeingusedmoreoften.Immuneneuropathiesassociatedwith
malignanciesandsystemicvasculiticdisordersarebeingdefinedfurtherand
treatedearlywithbetterunderstandingofthediseaseprocesses.Asthisfield
ofdysimmuneneuropathieswillevolveinthefuture,someofthecuriousaspects
oftheclinicalpresentationsandresponsepatternstodifferent
immunosuppressantsorimmunomodulatorswillbefurtherelucidated.Thisreview
alsodiscussesrepresentativecasestudies.
PMCID:
PMC3141494
PMID:
21808468[PubMed]
6.EurBiophysJ.2008Feb;37
(2):
183-95.Epub2007Sep5.
Membranepropertyabnormalitiesinsimulatedcasesofmildsystematicandsevere
focaldemyelinatingneuropathies.
StephanovaD
(1),DaskalovaM.
Authorinformation:
(1)InstituteofBiophysics,BulgarianAcademyofSciences,Acad.G.Bontchev
Str.,Bl.21,Sofia,1113,Bulgaria.dsteph@shiva.bio.bas.bg
Theinvestigationofmultiplenervemembranepropertiesbymathematicalmodels
hasbecomeanewtooltostudyperipheralneuropathies.Indemyelinating
neuropathies,themembranepropertiessuchaspotentials(intracellular,
extracellular,electrotonic)andindicesofaxonalexcitability
(strength-durationtimeconstants,rheobasesandrecoverycycles)cannowbe
measuredattheperipheralnerves.Thisstudyprovidesnumericalsimulationsof
themembranepropertiesofhumanmotornervefibreincasesofinternodal,
paranodalandsimultaneouslyofparanodalinternodaldemyelinations,eachofthem
mildsystematicorseverefocal.Thecomputationsuseourpreviousmulti-layered
modelofthefibre.Theresultsshowthattheabnormallygreaterincreaseofthe
hyperpolarizingelectrotonus,shorterstrength-durationtimeconstantsand
greateraxonalsuperexcitabilityintherecoverycyclesarethecharacteristic
featuresofthemildlysystematicallydemyelinatedcases.Thesmalldecreaseof
thepolarizingelectrotonicresponsesinthedemyelinatedzoneinturnleadstoa
compensatorysmallincreaseoftheseresponsesoutsidethedemyelinatedzoneof
allseverelyfocallydemyelinatedcases.Thepapersummarizestheinsightsgained
fromthesemodelingstudiesonthemembranepropertyabnormalitiesunderlyingthe
variationinclinicalsymptomsofdemyelinationinCharcot-Marie-Toothdisease
type1A,chronicinflammatorydemyelinatingpolyneuropathy,Guillain-Barré
syndromeandmultifocalmotorneuropathy.Themodelusedprovidesanobjective
studyofthemechanismsofthesediseaseswhichuptillnowhavenotbeen
sufficientlywellunderstood,becausequitedifferentassumptionshavebeengiven
intheliteraturefortheinterpretationofthemembranepropertyabnormalities
obtainedinhereditary,chronicandacquireddemyelinatingneuropathies.
PMID:
17786424[PubMed-indexedforMEDLINE]
7.JNeurolSci.2006May15;244(1-2):
77-87.Epub2006Mar9.
Thenaturalhistoryandlong-termoutcomeof57limbsarcoidosisneuropathy
cases.
BurnsTM
(1),DyckPJ,AksamitAJ,DyckPJ.
Authorinformation:
(1)DepartmentofNeurology,MayoClinicCollegeofMedicine,Rochester,MN55905,
USA.
Fifty-sevenpatientswithbiopsy-provensarcoidosiscausinglimbneuropathywere
reviewedinordertodelineatethecharacteristicsymptoms,impairments,
disability,course,outcomeandresponsetocorticosteroidtreatmentoflimb
sarcoidneuropathy.Typicallytheneuropathyhadadefinitedateofsymptomatic
onset.Prominentwerepositiveneuropathicsensorysymptoms(P-NSS),especially
pain,overshadowingweaknessandsensoryloss.P-NSSwerethemaincauseof
disability.Almostalwaysthepatternwas
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