CAJ | 학술논문

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.
목적 탐토당뇨병요저신경근신경총신경병(DLRPN)적림상화신경전생이학특점.방법 수집병분석15례DLRPN환자적림상자료화신경전생이학급신경영상학검사결과.결과 13례환자주요표현위단측혹비대칭성쌍측하지국조성동통,수질병진전출현기무력、기위축,하지근단교원단역수루.15례환자하지감각、운동주위신경전도동작전위파폭명현강저혹소실,반신경전도속도경도감만;F파、H반사미인출파형혹잠복기연장.침겁기전도현시하지다개기절실신경-신경재지배성개변,반요단척방기수루.결론 DLRPN림상표현구유계단성、치잔성,완선적신경전생리검사대명학진단、병변범위、정도급감별진단구유십분중요적작용.
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 latencies or absent. Electromyography 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% cases have much lower R-R interval variation. Conclusions DLRPN presents disabling pain and muscular weakness and elctrophysiological examination has a paramount value in the diagnosis and evaluation of this disease