Download PDF
Nervenheilkunde 2015; 34(05): 375-378
DOI: 10.1055/s-0038-1627596
Übersichtsartikel
Schattauer GmbH

Polyneuropathien

Diagnostik und TherapiePolyneuropathiesdiagnosis and treatment
C. Sommer
1   Neurologische Klinik, Universitätsklinikum Würzburg
,
K. Doppler
1   Neurologische Klinik, Universitätsklinikum Würzburg
› Author Affiliations
Further Information

Publication History

eingegangen am: 19 January 2015

angenommen am: 21 January 2015

Publication Date:
22 January 2018 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Polyneuropathien können vielfältige Ursachen haben, die Abklärung erfordert daher eine systematische Diagnostik, wie sie in einschlägigen Leitlinien dargelegt ist. Wichtig ist die Detektion von kausal behandelbaren Neuropathien, dies sind meist die infektiösen und Immunneuropathien, jedoch auch die Amyloidneuropathien und einige der metabolisch verursachten Formen. In dieser Übersicht sollen die Diagnostik und Therapie der Polyneuropathien, mit Fokus auf den Immunneuropathien, zusammengefasst werden.

Summary

Polyneuropathies can have many causes, their work-up therefore requires a systematic diagnostic pathway, as it is set out in the relevant guidelines. It is important to detect the treatable neuropathies, for example the infectious and immune neuropathies, but also amyloid neuropathies, and some forms of the metabolic neuropathies. Here we give an overview of the diagnosis and treatment of polyneuropathies with a focus on immune neuropathies.

Schlüsselwörter

Polyneuropathie - Vaskulitis - chronisch inflammatorische demyelinisierende Polyneuritis - Guillain-Barré-Syndrom

Keywords

Polyneuropathy - vasculitis - chronic inflammatory demyelinating polyneuropathy - GuillainBarré-Syndrome
 

  • Literatur

  • 1 Heuß D, Haupt WF, Kuntzer T, Löscher W, Neundörfe B, Rautenstrauß B, Renaud S, Sommer C. Diagnostik bei Polyneuropathien. In: Diener HC, Weimar C. (Hrsg.). Leitlinien für Diagnostik und Therapie in der Neurologie. Stuttgart: Thieme 2013: 578-91.
    Search in Google Scholar
  • 2 Brownell AA, Bromberg MB. Electrodiagnostic assessment of peripheral neuropathies. Semin Neurol 2010; 30: 416-24.
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Fuglsang-Frederiksen A, Pugdahl K. Current status on electrodiagnostic standards and guidelines in neuromuscular disorders. Clin Neurophysiol 2011; 122: 440-55.
    CrossrefPubMedSearch in Google Scholar
  • 4 Tankisi H, Pugdahl K, Fuglsang-Frederiksen A, Johnsen B, de Carvalho M, Fawcett PR, LabarreVila A, Liguori R, Nix WA, Schofield IS. Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies. Suggested guidelines. Clin Neurophysiol 2005; 116: 1571-80.
    CrossrefPubMedSearch in Google Scholar
  • 5 Chi LJ, Xu WH, Zhang ZW, Huang HT, Zhang LM, Zhou J. Distribution of Th17 cells and Th1 cells in peripheral blood and cerebrospinal fluid in chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst 2010; 15: 345-56.
    CrossrefPubMedSearch in Google Scholar
  • 6 Smith AG, Singleton JR. The diagnostic yield of a standardized approach to idiopathic sensory-predominant neuropathy. Arch Intern Med 2004; 164: 1021-5.
    CrossrefPubMedSearch in Google Scholar
  • 7 Sommer CL, Brandner S, Dyck PJ, Harati Y, LaCroix C, Lammens M, Magy L, Mellgren SI, Morbin M, Navarro C, Powell HC, Schenone AE, Tan E, Urtizberea A, Weis J. Peripheral Nerve Society Guideline on processing and evaluation of nerve biopsies. J Peripher Nerv Syst 2010; 15: 164-75.
    CrossrefPubMedSearch in Google Scholar
  • 8 England JD, Gronseth GS, Franklin G, Carter GT, Kinsella LJ, Cohen JA, Asbury AK, Szigeti K, Lupski JR, Latov N, Lewis RA, Low PA, Fisher MA, Herrmann D, Howard JF, Lauria G, Miller RG, Polydefkis M, Sumner AJ. Evaluation of distal symmetric polyneuropathy: the role of autonomic testing, nerve biopsy, and skin biopsy (an evidence-based review). Muscle Nerve 2009; 39: 106-15.
    CrossrefPubMedSearch in Google Scholar
  • 9 Gironi M, Saresella M, Marventano I, Guerini FR, Gatti A, Antonini G, Ceresa L, Morino S, Beghi E, Angelici A, Mariani E, Nemni R, Clerici M. Distinct cytokine patterns associated with different forms of chronic dysimmune neuropathy. Muscle Nerve 2010; 42: 864-70.
    CrossrefPubMedSearch in Google Scholar
  • 10 Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 2006; 10: 77-88.
    CrossrefPubMedSearch in Google Scholar
  • 11 Faber CG, Hoeijmakers JG, Ahn HS, Cheng X, Han C, Choi JS, Estacion M, Lauria G, Vanhoutte EK, Gerrits MM, Dib-Hajj S, Drenth JP, Waxman SG, Merkies IS. Gain of function Nanu1.7 mutations in idiopathic small fiber neuropathy. Ann Neurol 2012; 71: 26-39.
    CrossrefPubMedSearch in Google Scholar
  • 12 Faber CG, Lauria G, Merkies IS, Cheng X, Han C, Ahn HS, Persson AK, Hoeijmakers JG, Gerrits MM, Pierro T, Lombardi R, Kapetis D, Dib-Hajj SD, Waxman SG. Gain-of-function Nav1.8 mutations in painful neuropathy. Proc Natl Acad Sci USA 2012; 109: 19444-9.
    CrossrefPubMedSearch in Google Scholar
  • 13 Callaghan BC, Cheng HT, Stables CL, Smith AL, Feldman EL. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 2012; 11: 521-34.
    CrossrefPubMedSearch in Google Scholar
  • 14 Linn T, Ortac K, Laube H, Federlin K. Intensive therapy in adult insulin-dependent diabetes mellitus is associated with improved insulin sensitivity and reserve: a randomized, controlled, prospective study over 5 years in newly diagnosed patients. Metabolism 1996; 45: 1508-13.
    CrossrefPubMedSearch in Google Scholar
  • 15 Leypoldt F, Blaes F, Grisold W, Rauer S, Roelcke U, Voltz R, Wandinger KP, Weller M, Grabbe S, Hübner J, Kleeberg UR, Krege S, Singer S, Stummer W, Schreckenberger M, Wörmann B. Paraneoplastische neurologische Symptome. In: Diener HC, Weimar C. (Hrsg.). Leitlinien für Diagnostik und Therapie in der Neurologie. 5. Aufl. Stuttgart: Thieme 2012: 966-79.
    Search in Google Scholar
  • 16 Monaco S, Ferrari S, Gajofatto A, Zanusso G, Mariotto S. HCV-related nervous system disorders. Clin Dev Immunol 2012; 2012: 236148.
    PubMedSearch in Google Scholar
  • 17 Cacoub P, Terrier B, Saadoun D. Hepatitis C virusinduced vasculitis: therapeutic options. Ann Rheum Dis. 2013 6. August, E-pub.
    PubMedSearch in Google Scholar
  • 18 Coelho T, Maia LF, Martins Ada Silva, Waddington MCruz, Plante-Bordeneuve V, Lozeron P, Suhr OB, Campistol JM, Conceicao IM, Schmidt HH, Trigo P, Kelly JW, Labaudiniere R, Chan J, Packman J, Wilson A, Grogan DR. Tafamidis for transthyretin familial amyloid polyneuropathy: a randomized, controlled trial. Neurology 2012; 79: 785-92.
    CrossrefPubMedSearch in Google Scholar
  • 19 Coelho T, Maia LF, da Silva AM, Cruz MW, Plante-Bordeneuve V, Suhr OB, Conceicao I, Schmidt HH, Trigo P, Kelly JW, Labaudiniere R, Chan J, Packman J, Grogan DR. Long-term effects of tafamidis for the treatment of transthyretin familial amyloid polyneuropathy. J Neurol 2013; 260: 2802-14.
    CrossrefPubMedSearch in Google Scholar
  • 20 Lozeron P, Theaudin M, Mincheva Z, Ducot B, Lacroix C, Adams D. Effect on disability and safety of Tafamidis in late onset of Met30 transthyretin familial amyloid polyneuropathy. Eur J Neurol 2013; 20 (12) 1539-45.
    CrossrefPubMedSearch in Google Scholar
  • 21 Sommer C, Gold R, Hartung HP, Heuss D, Kieseier BC, Koeppen S, Steck AJ, Stoll G, Tackenberg B, Toyka KV, Zimpricht F. Therapie akuter und chronischer immunvermittelter Neuropathien und Neuritiden. In: Diener HC, Weimar C. (Hrsg.). Leitlinien für Diagnostik und Therapie in der Neurologie. 5. Aufl. Stuttgart: Thieme 2012: 592-606.
    Search in Google Scholar
  • 22 Diener HC, Haupt WF, Kloss TM, Rosenow F, Philipp T, Koeppen S, Vietorisz A. A preliminary, randomized, multicenter study comparing intravenous immunoglobulin, plasma exchange, and immune adsorption in Guillain-Barre syndrome. Eur Neurol 2001; 46: 107-9.
    CrossrefPubMedSearch in Google Scholar
  • 23 Hughes RA. Plasma exchange versus intravenous immunoglobulin for Guillain-Barre syndrome. Ther Apher 1997; 01: 129-30.
    CrossrefPubMedSearch in Google Scholar
  • 24 Nobile-Orazio E, Cocito D, Jann S, Uncini A, Beghi E, Messina P, Antonini G, Fazio R, Gallia F, Schenone A, Francia A, Pareyson D, Santoro L, Tamburin S, Macchia R, Cavaletti G, Giannini F, Sabatelli M. Intravenous immunoglobulin versus intravenous methylprednisolone for chronic inflammatory demyelinating polyradiculoneuropathy: a randomised controlled trial. Lancet Neurol 2012; 11: 493-502.
    CrossrefPubMedSearch in Google Scholar
  • 25 Eftimov F, Vermeulen M, van Doorn PA, Brusse E, van Schaik IN. Long-term remission of CIDP after pulsed dexamethasone or short-term prednisolone treatment. Neurology 2012; 78: 1079-84.
    CrossrefPubMedSearch in Google Scholar
  • 26 Hummel HD, Rath JC, Wiendl H, Hetzel W, Bargou RC, Toyka KV, Sommer C, Einsele H, Topp MS. Auto-SCT in severe paraproteinemic neuropathy. Bone Marrow Transplant 2011; 46 (03) 457-9.
    CrossrefPubMedSearch in Google Scholar
  • 27 Press R, Askmark H, Svenningsson A, Andersen O, Axelson HW, Stromberg U, Wahlin A, Isaksson C, Johansson JE, Hagglund H. Autologous haematopoietic stem cell transplantation: a viable treatment option for CIDP. J Neurol Neurosurg Psychiatry 2014; 85 (06) 618-24.
    CrossrefPubMedSearch in Google Scholar
  • 28 Harbo T, Andersen H, Hess A, Hansen K, Sindrup SH, Jakobsen J. Subcutaneous versus intravenous immunoglobulin in multifocal motor neuropathy: a randomized, single-blinded cross-over trial. Eur J Neurol 2009; 16: 631-8.
    CrossrefPubMedSearch in Google Scholar
  • 29 Eftimov F, Vermeulen M, de Haan RJ, van den Berg LH, van Schaik IN. Subcutaneous immunoglobulin therapy for multifocal motor neuropathy. J Peripher Nerv Syst 2009; 14: 93-100.
    CrossrefPubMedSearch in Google Scholar
  • 30 European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society – first revision. J Peripher Nerv Syst 2010; 15: 295-301.
    CrossrefPubMedSearch in Google Scholar
  • 31 Baron R, Binder A, Birklein F, Maier C, Quasthoff S, Sommer C, Tölle TR, Wasner G, Ziegler D. Pharmakologische nicht interventionelle Therapie chronisch neuropathischer Schmerzen. In: Diener HC, Weimar C. (Hrsg.). Leitlinien für Diagnostik und Therapie in der Neurologie. Stuttgart: Thieme 2012: 771-83.
    Search in Google Scholar
  • 32 Bundesärztekammer (BÄK) KBK, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale VersorgungsLeitlinie Neuropathie bei Diabetes im Erwachsenenalter – Langfassung. Version 1.X. Available from: http://wwwdiabetesversorgungsleitli-niende,http://wwwversorgungsleitliniende,http://wwwawmf-leitliniende2011.
  • 33 Attal N, Cruccu G, Baron R, Haanpaa M, Hansson P, Jensen TS, Nurmikko T. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010; 17: 1113-e88.
    CrossrefPubMedSearch in Google Scholar
  • 34 Siepmann T, Penzlin AI, Illigens BM. Autonome Nervenkrankheiten--Früherkennung und leitliniengerechte Behandlung. Dtsch Med Wochenschr 2013; 138: 1529-32.
    Thieme ConnectPubMedSearch in Google Scholar