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慢性炎性脱髓鞘性多神经病(CIDP)被视为限于周围神经系统(PNS)的疾病。晚近用MRI研究发现,该病常合并CNS的MS样病变,或与MS并存。但CIDP中枢病变的发生率迄今未明。作者对8年来的19例CIDP病人进行了脑MRI研究。结果:19例起病年龄7～68岁(平均39.5),男12例。均符合CIDP的临床诊断标准。16例同时有双手姿位性和意向性震颤。16/18例CSF蛋白升高。全部有神经传导速度减慢,12/13例传导阻滞。8例的感觉电位消失,10例的振幅减低,另1例正常。16例完成腓浅、腓深或腓肠神经活检,15例有髓鞘脱失,10例有单核细胞浸润。全部经过治疗,其中血浆置换法14例,硫唑嘌吟12例和类固醇激素19例。
Chronic inflammatory demyelinating polyneuropathy (CIDP) is considered a disease limited to the peripheral nervous system (PNS). Recent MRI study found that the disease often associated with MS-like lesions of CNS, or with MS co-exist. However, the incidence of CIDP central lesions so far is not yet clear. The authors performed brain MRI studies of 19 CIDP patients over the past eight years. Results: The onset age of 19 patients was 7 to 68 years old (average 39.5), 12 males. All meet the clinical diagnostic criteria of CIDP. 16 cases both hands position and intention tremor. 16/18 cases of CSF protein increased. All nerve conduction slowed down, 12/13 cases of conduction block. The sensory potential of 8 patients disappeared, the amplitude of 10 patients decreased and the other 1 patient was normal. In 16 cases, the superficial peroneal, peroneal deep or sural nerve biopsy was completed, 15 cases had myelinocele debridement and 10 cases had mononuclear cell infiltration. All after treatment, including 14 cases of plasma exchange, azathioprine 12 cases and steroid hormone in 19 cases.