مرکز منطقه ای اطلاع رساني علوم و فناوري - بررسي اختلالات هدايت اعصاب محيطي و الكتروميوگرافي دركودكان مبتلا به پلي نوروپاتي حاد التهابي و مراجعه كننده به بيمارستان گلستان اهواز

چكيده لاتين :

Objective: Acute inflammatory demyelinating polyradiculoneuropathy is an immune system-mediated and acquired polyneuropathy. It usually presents with weakness which progresses during the first weeks of disease to produce a flaccid paralysis. Electrophysiological findings play an important part in the diagnosis and prognosis of the disease. For a clinician it is important to correlate the clinical manifestation and laboratory findings of the patients with the electrophysiological data, especially when the patients with acquired neuropathies are more treatable than patients suffered from hereditary neuropathies. Because the acquired neuropathies usually have an acute course, based on the time from the onset and the type of peripheral nerve involvement, the electrophysiological changes could be different. Therefore it is essential to find the electrophysiological changes following the weakness caused by acute inflammatory demyelization polyradiculoneuropathy in order to diagnose and evaluate the undergoing pathogenesis. Subjects and Methods:: This study was undertaken from 2004 to 2007 on thirty patients with the clinical impression of acute inflammatory demyelinating polyradiculoneuropathy referred to pediatric emergency room and ward of Ahvaz Golestan hospital evaluated by measuring their nerve conduction velocities and limb electromyography at room temperature. Nerve conduction studies were done by measuring nerve conduction velocities of deep peroneal and posterior tibial nerves bilaterally; recording sural nerves action potentials, determination of F wave latencies of posterior tibial and deep peroneal nerves bilaterally. In addition, compound motor action potentials of tibial and peroneal nerves were obtained from the extensor digitorum brevis and abductor hallucis longus muscles. Needle electromyography examinations of the lower and upper extremities were done at the time of nerve conduction studies at the room temperature. Results: Conduction disturbances were the most detectable electrophysiological finding among the studied group. Between thirteen to twenty percent of patients showed F-latency abnormalities. Sural nerve action potential amplitudes were within normal values. The durations and amplitudes of compound muscle action potentials were impaired. Decreased motor unit interferences were the most obtainable electromyographic abnormalities among the patients. Conclusion: Conduction disturbances are the most common electrophysiological abnormality among the studied group. The information obtained from this study suggests that nerve conduction velocities and limb electromyography assessment can be used to confirm the diagnosis of acute inflammatory demyelinating polyradiculoneuropathy, classify the subtypes of the disease and to predict the prognosis.