بررسي برخي علل شايع پلينوروپاتي در بيمارستان 22 بهمن مشهد

Evaluation of some prevalent causes of Polyneuropathy in patients referring to the neurologic outpatient clinic of Bahman

Polyneuropathy is defined as a diffused peripheral nerve disorder that presents with sensory, motor or autonomic dysfunctions. This study aims at determining the causes of polyneuropathy among patients who referred to Bahman 22nd Hospital in Mashhad. This is a descriptive study that was carried out on 31 patients suspected to polyneuropathy referring to Bahman 22nd Hospital in Mashhad during the years of 2007-2008. The study collected data on the patientsʹ past medical history, drug history and family history of manifesting similar symptoms. Also, the research undertook neurological examinations and neurophysiologic studies on all the participating patients. Polyneuropathy was confirmed using electrophysiologic studies. Supplementary laboratory exams were conducted with patientsʹ consent to diagnose polyneuropathy. Statistical analysis was then done on the collected data using SPSS software. Results The most frequent cause of polyneuropathy was found to be CIDP. The other causes were determined as diabetes mellitus in 16.5% of the participants, GBS in 16.5% as well as leprosy, toxic and hereditary causes each in 9.7% of the participants . Also Vitamine B12 deficiency was determined to be the cause in 6.5% of the cases. We didnʹt find any determinative cause of the disease in 9.7% of the cases; so, they were classified as cryptogenic. Among the predominating clinical manifestation was sensory complains (66.1%). Pain and temperature disorders were the most common presentations (87.1%). It was also found that muscle tonicity affected mostly the distal area of lower extremities. Muscle strength was found to be diminished in the distal areas of both lower and upper extremities. Moreover, Achilles Reflex function was reduced in 87.1% of the patients in this study. Conclusion The most frequent causes of polyneuropathy were inflammation and metabolic disorders. Muscle tonicity, muscle strength and deep tendon reflexes were reduced in the distal areas of extremities. Therefore, in neurological examinations, detailed evaluation of distal areas is essential.