% 0期刊文章% Johanna。哈默尔%埃里克·l·Logigian % T急性营养患者的临床表现和预后轴突神经病变% D R 10.1212 / WNL 2023%。0000000000207215 % J首页神经病学% P e2134-e2140 % V 100% N 20% X背景和目标描述的临床,微量营养素和电生理学的光谱和预后患者急性营养轴突神经病变(安安)。方法患者的死因被确定在1999年和2020年之间的回顾性研究的EMG数据库和电子健康记录和分类的临床和电诊法的理由,作为纯粹的感觉,感觉运动,或纯粹的电动机;和风险因素(酒精使用障碍,减肥手术,或厌食症)。实验室异常记录包括硫胺素,维生素B6, B12和维生素E,叶酸和铜。步和神经性疼痛状态最后随访记录。结果患者40安安,21个酒精使用障碍,10个厌食症患者,9最近经历了减肥手术。他们的神经病变是纯粹的感官在14低硫胺素(7),在23个低硫胺素(8),感觉运动和纯电机3与低硫胺(1)。维生素B1是最常见的低(85%),其次是维生素B6(77%)和叶酸(50%)。风险因素和神经病变类型并不与特定微量营养素缺乏关联。 Of the 37 patients who were seen in follow-up, only 13 (35%) were walking independently, and only 8 (22%) were pain free at the last follow-up visit at a mean of 22 months (range 2–88 months) from onset.Discussion The spectrum of ANAN is wide, ranging from: (1) a pure sensory neuropathy with areflexia, limb and gait ataxia, neuropathic pain, and unevocable sensory responses to (2) a motor axonal neuropathy with low-amplitude motor responses without conduction slowing, block, or dispersion, and (3) a mixed sensorimotor axonal polyneuropathy. Specific micronutrient deficiencies or risk factors do not predict neuropathy subtype. The subgroup of patients with ANAN with documented thiamine deficiency also range from pure sensory to pure motor, and only a minority have Wernicke encephalopathy. We do not know whether coexistent micronutrient deficiencies may help explain the wide clinical spectrum of thiamine-deficient ANAN. The prognosis of ANAN is guarded due to residual neuropathic pain and slow recovery of independent ambulation. Therefore, early recognition of patients at risk is important.ANAN=acute nutritional axonal neuropathy; GBS=Guillain-Barre syndrome; GI=gastrointestinal; IVIg=IV immunoglobulin; MCV=mean corpuscular volume %U //www.ez-admanager.com/content/neurology/100/20/e2134.full.pdf