4例异烟肼致周围神经病患者的电生理特点及文献复习

Electrophysiological characteristics of 4 patients with isoniazid induced peripheral neuropathy and literature review

目的探讨异烟肼所致周围神经病的临床特点及电生理改变。方法对4例异烟肼所致周围神经病患者的临床及电生理特点进行总结,并进行文献回顾性分析。结果周围神经病是异烟肼常见的不良反应,主要表现为痛性感觉过敏及感觉异常,以感觉神经受累为主,严重者可累及运动神经,下肢重于上肢,神经传导速度测定呈现对称性感觉神经及运动神经动作电位波幅减低或消失,潜伏期及传导速度正常。电生理特点为对称性、长度依赖性轴索型感觉运动神经病。结论异烟肼可导致周围神经病损,神经电生理检查可作为早期诊断依据,早期呈可逆性,停药并辅以维生素B6治疗有效。

Objective To explore the clinical characteristics and electrophysiological changes of peripheral neuropathy caused by isoniazid. Methods The clinical and electrophysiological characteristics of 4 patients with isoniazid induced peripheral neuropathy were summarized, and the literatures were analyzed retrospectively. Results Peripheral neuropathy is a common side effect of isoniazid, which is mainly manifested as hyperalgesia and paresthesia, mainly involving sensory nerve;in severe cases, motor nerves may be involved;lower limbs are more severe than upper limbs, and nerve conduction velocity measurements show the action potential amplitudes of symmetric sensory and motor nerve decrease or disappear,and latency and conduction velocity are normal. Electrophysiological characteristics are symmetrical and length-dependent axonal sensorimotor peripheral polyneuropathy. Conclusion Isoniazid can lead to peripheral nerve lesions,electrophysiological examination can be used as the basis for the early diagnosis. It was reversible in the early stage,withdrawal and supplementation with vitamin B6 treatment was effective.