周 围 神 经 病教学文稿.ppt

周 围 神 经 病 Peripheral Neuropathy;Anatomy cranial nerve;Spinal nerves;Histology;Electrophysiology;Functions;Step 1: Clinical features of neuropathies—— history and examination of patient is the clues to diagnosis of neuropathy;Muscle weakness;tips: Lower motor neurogenic damage Anatomic distribution Symmetric proximal distal Asymmetricsingle nerve multiple nerveplexus nerve root;Sensory abnormalities;tips: Hearing patient’s description Anatomic distribution Symmetric “Glove and Stocking” distribution Asymmetric single nerve multiple nerve plexus nerve root;Autonomic Nerve Damage;Step 2: Laboratory findings;Step3: causes  Disease;神经病伴肿瘤 肿瘤的远隔效应 肿瘤直接浸润 异常球蛋白血征相关的神经病 感染相关的神经病 HIV 麻风 Lyme 病 带状疱疹;Pathomechanism;周围神经病的临床病理分类;吉兰—巴雷综合征  Guillain-Barre syndrome;Guillain-Barre syndrome;Pathologic changes of AIDP;Mechanism——Antecedent events for GBS;Antecedent events for GBS;Immunopathology Mechanism molecular mimicry ;Classification of GBS;Concept of GBS;Epidemiology;Clinical features of AIDP(1);Clinical features of AIDP(2);Neurologic examination;CSF;Electro-diagnostic studies;Sural nerve biopsy;Course ;Diagnosis;Differential diagnosis;Treatment of GBS （1）;Treatment of GBS （2）;Prognosis;Chronic inflammatory demyelinating polyradiculoneuritis (CIDP);单神经病和多发单神经病mononeuropathy and multiple mononeuropathies;常见疾病举例： 1、颅神经：动眼神经麻痹，面神经麻痹，面肌痉挛，三叉神经痛;2、臂丛神经炎，肘管综合症（尺神经麻痹），腕管综合症（正中神经麻痹），桡神经麻痹;3、肋间神经、躯干神经4、坐骨神经痛，股外侧皮神经炎，腓总神经麻痹，胫神经麻痹;周围神经病常见病因;血管炎;中毒性神经病 药物 酒精 金属 ?化学物质 维生素缺乏 维生素B1 维生素B12 维生素 E;遗传性神经病;遗传性运动感觉神经病（hereditary motor sensory neuropathy, HMSN）又称腓骨肌萎缩症（Charcot-Merie-Tooth 综合征CMT）;遗传性压迫易感性神经病;Fabry 病;家族遗传性淀粉样变性神经病;神经病伴肿瘤 肿瘤的远隔效应 肿瘤直???浸润 异常球蛋白血征相关的神经病 感染相关的神经病 HIV 麻风 Lyme 病 带状疱疹;麻风病神经病;治疗