Clinicopathological analysis of chronic inflammatory demyelinating polyneuropathy in the elderly
- VernacularTitle:老年人慢性炎症性脱髓鞘性多发性神经病临床病理分析
- Author:
Ning ZHANG
;
Gang LI
;
Bo XIAO
;
Yunhai LIU
;
Yan CAI
;
Jinghui LIANG
- Publication Type:Journal Article
- Keywords:
Polyradiculoneuropathy,chronic inflammatory demyelinating;
Cuillain-Barre syndrome;
Pathology,clinical
- From:
Chinese Journal of Geriatrics
2008;27(8):579-581
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical and pathological features in the elderly patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Methods The features of the clinical manifestation, cerebrospinal fluid, electromyogram(EMG) and the biopsy results of sural nerve were presented and analyzed in 11 elderly patients with CIDP. Results Two cases had history of upper respiratory tract infection before the onset. As the initial symptoms , there were three cases with distal limb numbness, five cases with both distal lower extremities numbness, two cases with both distal upper extremities numbness and one case with difficulties to raise his head. Motor disorder was common to all the patients. There were eight patients with sensory dysfunction, three with limb muscle atrophy, one with muscle tenderness, eight with tendon reflexes weakened or disappeared, five with cranial nerve damaged, three with the autonomic nerve lesion, one with respiratory muscle involved, three with relapse. The score of the peak incidence as Modified Rankin was 3.02 points on average. Five cases had obvious albuminocytolgoic dissociation by the examination of cerebrospinal fluid, ten cases had neurogenic damage and one case had a combined myogenic and neurogenic damage by the EMG. The biopsy showed that six cases were with amyelination,six cases with inflammatory cell infiltrated, two cases with obvious remyelination, two cases with auxiliary fibers degeneration.And the methylprednisolone therapy was effective for eight cases. Conclusions The numbness of the distal limb is the initial symptom of the elderly patients with CIDP,most of whom are with sensory dysfunction ,and some with cranial nerves and autonomic nerve damage. The sural nerve biopsy has an important value for the diagnosis of the elderly with CIDP. The methylprednisolone therapy is proved to be effective for most patients.
