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没有ENMG,检测儿科温克里斯神经病变是一个挑战
Kreeta Viinikainen1, Pirjo Isohanni1,2, Jukka Kanerva3
1Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.
Clinical neurophysiology practice
|March 5, 2024
概括
温克里斯诱导的周围神经病变 (VIPN) 在患有白血病的儿童中很常见. 电神经肌图 (ENMG) 可以检测早期的VIPN,仅通过临床检查就可能错过.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 儿科 儿科 儿科
背景情况:
- 文克里斯是一种用于治疗儿童白血病的化疗药物.
- 文克里斯可以引起周围神经病变 (PNP),一种影响神经的疾病.
- 这种神经病变被称为温克里斯诱导的外周神经病变 (VIPN),可能导致持久的功能障碍.
研究的目的:
- 研究在接受早期白血病治疗的儿童中VIPN的发生和进展.
- 在儿科患者中描述因温克里斯引起的特定类型的神经病变.
主要方法:
- 一项前性研究涉及35名患有急性淋巴细胞白血病 (ALL) 的儿科患者.
- 在诊断和早期治疗期间进行了系统的临床评估和电生理学研究 (电神经图 - ENMG).
- 使用ENMG来评估神经功能和检测神经病变.
主要成果:
- 所有患者在接受温克里斯治疗后都出现了轴突传感运动PNP,通过ENMG证实了这一点.
- 大多数患者的运动和感觉神经反应都减少了 (34/35运动,24/35感觉).
- 在某些情况下,PNP在上肢更为明显,临床症状并不总是与ENMG发现相关.
结论:
- 儿科VIPN主要是一种感觉运动轴突神经病变,主要有运动部件.
- 对于检测早期VIPN而言,ENMG至关重要,因为仅仅临床症状可能是微妙的或不存在的.
- 用温克里斯治疗的ALL儿童患有VIPN的风险很高,如果没有电生理学评估,可以很容易忽略这一点.
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