多发性单神经病讲解.docx
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多发性单神经病讲解.docx
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多发性单神经病讲解
multiplemononeuropathy
1.NeurolNeuroimmunolNeuroinflamm.2015Nov12;3
(1):
e180.doi:
10.1212/NXI.0000000000000180.eCollection2016.
Vasculiticneuropathyfollowingexposuretominocycline.
BarattaJM
(1),DyckPJ
(1),BrandP
(1),ThaisetthawatkulP
(1),DyckPJ
(1),
EngelstadJK
(1),GoodmanB
(1),KaramC
(1).
Authorinformation:
(1)DepartmentsofPhysicalMedicine&Rehabilitation(J.M.B.)andNeurology
(C.K.),TheUniversityofNorthCarolina,ChapelHill;theDepartmentof
Neurology(P.J.B.D.,P.B.,P.J.D.,J.K.E.),MayoClinic,Rochester,MN;the
DepartmentofNeurologicalSciences(P.T.),UniversityofNebraskaMedical
Center,Omaha;andtheDepartmentofNeurology(B.G.),MayoClinic,Scottsdale,
AZ.
OBJECTIVE:
Toreport3patientswithminocycline-inducedautoimmunityresulting
inperipheralnervevasculitis.
METHODS:
Wereport3patientswho,duringminocyclinetreatmentforacne
vulgaris,developedsubacuteonsetofpainandweaknesscausedbyvasculitisin
singleandmultiplemononeuropathypatterns.
RESULTS:
Eachpatientunderwenteitheranerveormusclebiopsythatconfirmed
vasculitis.Onepatientadditionallydevelopedsystemicsymptoms(including
fever,fatigue,andnightsweats)andanotherhadaposteriorcirculationstroke.
Symptomsdevelopedwitheitherearlyorprolongeduseofminocycline.Despite
withdrawalofminocycline,patientsneededlong-termimmunotherapytogain
neurologicimprovement.
CONCLUSIONS:
Ourfindingssuggestthatthetypicalneuropathyassociatedwith
minocyclineuseispainfulsingleormultiplemononeuropathyduetoperipheral
nervevasculitis,whichmayalsobeaccompaniedbypresumedCNSvasculitis
(presentingasstroke).
PMCID:
PMC4645168
PMID:
26601119[PubMed]
2.JAMANeurol.2015Dec1;72(12):
1510-8.doi:
10.1001/jamaneurol.2015.2347.
TheImportanceofRareSubtypesinDiagnosisandTreatmentofPeripheral
Neuropathy:
AReview.
CallaghanBC
(1),PriceRS
(2),ChenKS(3),FeldmanEL
(1).
Authorinformation:
(1)DepartmentofNeurology,UniversityofMichigan,AnnArbor.
(2)Departmentof
Neurology,UniversityofPennsylvania,Philadelphia.(3)Departmentof
Neurosurgery,UniversityofMichigan,AnnArbor.
IMPORTANCE:
Peripheralneuropathyisaprevalentconditionthatusuallywarrants
athoroughhistoryandexaminationbuthaslimiteddiagnosticevaluation.
However,rarelocalizationsofperipheralneuropathyoftenrequiremoreextensive
diagnostictestinganddifferenttreatments.
OBJECTIVE:
Todescriberarelocalizationsofperipheralneuropathy,includingthe
appropriatediagnosticevaluationandavailabletreatments.
EVIDENCEREVIEW:
ReferenceswereidentifiedfromPubMedsearchesconductedonMay
29,2015,withanemphasisonsystematicreviewsandrandomizedclinicaltrials.
Articleswerealsoidentifiedthroughtheuseoftheauthors'ownfiles.Search
termsincludedcommonrareneuropathylocalizationsandtheircauses,aswellas
epidemiology,pathophysiology,diagnosis,andtreatment.
FINDINGS:
Diffuse,nonlength-dependentneuropathies,multiplemononeuropathies,
polyradiculopathies,plexopathies,andradiculoplexusneuropathiesarerare
peripheralneuropathylocalizationsthatoftenrequireextensivediagnostic
testing.Atypicalneuropathyfeatures,suchasacute/subacuteonset,asymmetry,
and/ormotorpredominantsigns,arefrequentlypresent.Themostcommondiffuse,
nonlength-dependentneuropathiesareGuillain-Barrésyndrome,chronic
inflammatorydemyelinatingpolyneuropathy,multifocalmotorneuropathy,and
amyotrophiclateralsclerosis.Effectivedisease-modifyingtherapiesexistfor
manydiffuse,nonlength-dependentneuropathiesincludingGuillain-Barrésyndrome,
chronicinflammatorydemyelinatingpolyneuropathy,multifocalmotorneuropathy,
andsomeparaprotein-associateddemyelinatingneuropathies.Vasculiticneuropathy
(multiplemononeuropathy)alsohasefficacioustreatmentoptions,butdefinitive
evidenceofatreatmenteffectforIgManti-MAGneuropathyanddiabetic
amyotrophy(radiculoplexusneuropathy)islacking.
CONCLUSIONSANDRELEVANCE:
Recognitionofrarelocalizationsofperipheral
neuropathyisessentialgiventheimplicationsfordiagnostictestingand
treatment.Electrodiagnosticstudiesareanimportantearlystepinthe
diagnosticevaluationandprovideinformationonthelocalizationand
pathophysiologyofnerveinjury.
PMID:
26437251[PubMed-inprocess]
3.AnnRehabilMed.2015Oct;39(5):
833-7.doi:
10.5535/arm.2015.39.5.833.Epub2015
Oct26.
MultipleLowerExtremityMononeuropathiesbySegmentalSchwannomatosis:
ACase
Report.
KwonNY
(1),OhHM
(1),KoYJ
(1).
Authorinformation:
(1)DepartmentofRehabilitationMedicine,CollegeofMedicine,TheCatholic
UniversityofKorea,Seoul,Korea.
Schwannomaisanencapsulatednervesheathtumorthatisdistinctfrom
neurofibromatosis.Itisdefinedastheoccurrenceofmultipleschwannomas
withoutanybilateralvestibularschwannomas.A46-year-oldmanwithmultiple
schwannomasinvolvingperipheralnervesoftheipsilaterallowerextremity
presentedwithneurologicsymptoms.Electrodiagnosticstudiesrevealedmultiple
mononeuropathiesinvolvingtheleftsciatic,commonperoneal,tibial,femoraland
superiorglutealnerves.Histologicfindingsconfirmedthediagnosisof
schwannoma.Wereportedthisrarecaseofsegmentalschwannomatosisthat
presentedwithneurologicsymptomsincludingmotorweakness,whichwasconfirmed
asmultiplemononeuropathiesbyelectrodiagnosticstudies.
PMCID:
PMC4654091
PMID:
26605183[PubMed]
4.MuscleNerve.2015Jul;52
(1):
151-2.doi:
10.1002/mus.24617.
Brachioplasty-associatedmultiplemononeuropathies.
ThawaniSP
(1),BieriP
(2),HerskovitzS
(2).
Authorinformation:
(1)PeripheralNeuropathyCenter,TheNeurologicalInstituteofNewYork,Columbia
UniversityMedicalCenter,NewYork,NewYork,USA.
(2)AlbertEinsteinCollegeof
Medicine,MontefioreMedicalCenter,Bronx,NewYork,NewYork,USA.
PMID:
25703458[PubMed-indexedforMEDLINE]
5.Neuron.2015Jun3;86(5):
1215-27.doi:
10.1016/j.neuron.2015.05.005.Epub2015
May21.
RobustAxonalRegenerationOccursintheInjuredCAST/EiMouseCNS.
OmuraT
(1),OmuraK
(1),TedeschiA
(1),RivaP
(1),PainterMW
(1),RojasL
(1),
MartinJ
(1),LisiV
(2),HuebnerEA
(1),LatremoliereA
(1),YinY
(1),Barrett
LB
(1),SinghB
(1),LeeS
(1),CrismanT(3),GaoF(3),LiS(4),KapurK
(1),
GeschwindDH(3),KosikKS
(2),CoppolaG(3),HeZ
(1),CarmichaelST(4),Benowitz
LI
(1),CostiganM(5),WoolfCJ(6).
Authorinformation:
(1)F.M.KirbyNeurobiologyCenter,BostonChildren'sHospitalandHarvardMedical
School,Boston,MA02115,USA.
(2)NeuroscienceResearchInstitute,Departmentof
Molecular,Cellular,andDevelopmentalBiology,UniversityofCalifornia,Santa
Barbara,SantaBarbara,CA93106,USA.(3)DepartmentsofPsychiatryand
Neurology,SemelInstituteforNeuroscienceandHumanBehavior,DavidGeffen
SchoolofMedicine,UniversityofCalifornia,LosAngeles,LosAngeles,CA90095,
USA.(4)DepartmentofNeurology,DavidGeffenSchoolofMedicine,andMultiple
MyelomaResearchConsortium,SemelInstituteforNeuroscienceandHumanBehavior,
UniversityofCalifornia,LosAngeles,LosAngeles,CA90095,USA.(5)F.M.Kirby
NeurobiologyCenter,BostonChildren'sHospitalandHarvardMedicalSchool,
Boston,MA02115,USA;AnaesthesiaDepartment,BostonChildren'sHospitaland
HarvardMedicalSchool,Boston,MA02115,USA.Electronicaddress:
michael.costigan@childrens.harvard.edu.(6)F.M.KirbyNeurobiologyCenter,Boston
Children'sHospitalandHarvardMedicalSchool,Boston,MA02115,USA.Electronic
address:
clifford.woolf@childrens.harvard.edu.
AxonregenerationintheCNSrequiresreactivatinginjuredneurons'intrinsic
growthstateandenablinggrowthinaninhibitoryenvironment.Usinganinbred
mouseneuronalphenotypicscreen,wefindthatCAST/Eimouseadultdorsalroot
ganglionneuronsextendaxonsmoreonCNSmyelinthantheothereightstrains
tested,especiallywhenpre-injured.Injury-primedCAST/Eineuronsalso
regeneratemarkedlyinthespinalcordandopticnervemorethanthosefrom
C57BL/6miceandshowgreatersproutingfollowingischemicstroke.Heritability
estimatesindicatethatextendedgrowthinCAST/Eineuronsonmyelinis
geneticallydetermined,andtwowhole-genomeexpressionscreensyieldtheActivin
transcriptInhbaasmostcorrelatedwiththisability.InhibitionofActivin
signalinginCAST/EimicediminishestheirCNSregenerativecapacity,whereasits
activationinC57BL/6animalsboostsregeneration.Thisscreendemonstratesthat
mammalianCNSregenerationcanoccurandrevealsamolecularpathwaythat
contributestothisability.
Copyright©2015ElsevierInc.Allrightsreserved.
PMCID:
PMC4458182[Availableon2016-06-03]
PMID:
26004914[PubMed-indexedforMEDLINE]
6.NeurosciLett.2015Jun2;596:
3-13.doi:
10.1016/j.neulet.2015.02.038.Epub2015
Feb19.
Advancesindiagnosticsandoutcomemeasuresinperipheralneuropathies.
MerkiesIS
(1),FaberCG
(2),LauriaG(3).
Authorinformation:
(1)DepartmentofNeurology,SpaarneHospital,Hoofddorp,TheNetherlands;
DepartmentofNeurology,MaastrichtUniversityMedicalCenter,Maastricht,The
Netherlands.
(2)DepartmentofNeurology,MaastrichtUniversityMedicalCenter,
Maastricht,TheNetherlands.(3)3rdNeurologyUnit,IRCCSFoundation"Carlo
Besta"NeurologicalInstitute,Milan,Italy.Electronicaddress:
glauria@istituto-besta.it.
Peripheralneuropathiesareagroupofacquiredandhereditarydisorders
presentingwithdifferentdistributionandnervefiberclassinvolvement.The
overallprevalenceis2.4%,increasingto8%intheelderlypopulation.However,
thefrequencymayvarydependingontheunderlyingpathogenesisandassociation
withsystem
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