摘要
目的探讨糖尿病腰骶神经根神经丛神经病（DLRPN）的临床和神经电生理学特点。方法收集并分析15例DLRPN患者的，临床资料和神经电生理学及神经影像学检查结果。结果13例患者主要表现为单侧或非对称性双侧下肢局灶性疼痛，随疾病进展出现肌无力、肌萎缩，下肢近端较远端易受累。15例患者下肢感觉、运动周围神经传导动作电位波幅明显降低或消失，伴神经传导速度轻度减慢；F波、H反射未引出波形或潜伏期延长。针极肌电图显示下肢多个肌节失神经－神经再支配性改变，伴腰段脊旁肌受累。结论DLRPN临床表现具有阶段性、致残性，完善的神经电生理检查对明确诊断、病变范围、程度及鉴别诊断具有十分重要的作用。
Objective To explore the clinical and electrophysiological characteristics of diabetic lumbosacral radiculoplexus neuropathy （ DLRPN）. Methods The clinical, electrophysiological and neuroimaging changes in 15 cases of DLRPN were investigated. Results The major clinical manifestations of 13 cases were unilateral or asymmetrical pain and progressive muscular weakness and atrophy of the proximal lower limb. The nerve conduction studies in affected nerves showed absent or reduced compound muscle action potential amplitudes and sensory responses with proportionate slowing of the conduction velocities. F waves and H reflexes were of long lateneies or absent. Eleetromyography of affected muscles showed positive sharp waves and fibrillation potentials involving lumbar paraspinal muscles. Assessment of the motor unit action potentials （MUAPs） revealed high amplitude,long duration, and polyphasic MUAPs with reduced recruitment. 50% eases have much lower R-R interval variation. Conclusions DLRPN presents disabling pain and muscular weakness and elctrophysiologieal examination has a paramount value in the diagnosis and evaluation of this disease
出处
《中国综合临床》
2010年第10期1054-1056,共3页
Clinical Medicine of China
关键词
糖尿病
神经根
神经丛
神经电生理
Diabetic
Nerve root
Nerve plexus
Electrophysiology
