目的研究经基因诊断确诊的遗传性压迫易感性神经病(hereditary neuropathy with liability to pressure palsies,HNPP)患者的临床特点和电生理特征。方法对来自4个家系的5例HNPP患者进行基因诊断,并总结患者的临床特点,同时分析其电生理特征,包括肌电图(EMG)、运动神经传导速度(MCV)和感觉神经传导速度(SCV)。结果5例患者均存在周围髓鞘蛋白22 (peripheral myelination protein 22,PMP22)基因缺失。HNPP临床主要表现为反复发作的肢体麻木、无力,神经传导存在广泛异常。结论电生理检查对HNPP的诊断很重要,基因检测发现PMP22基因缺失是诊断HNPP的金标准。
遗传性压力易感性周围神经病(Hereditary neuropathy with liability to pressure palsies,HNPP)是由人类周围髓鞘蛋白22(peripheral myelin protein 22,PMP22)基因缺失突变或点突变引起的一种少见的常染色体显性遗传性周围神经病。HNPP多于20~30岁起病,以易卡压部位神经受到轻微牵拉或压迫后反复出现受累神经支配区域的麻木和无力为主要临床特征。
A cohort of 404 patients referred for hereditary neuropathy with liability to pressure palsies was tested initially for the common PMP22 whole gene deletion. 94 whole gene deletions were detected, plus three partial gene deletions, and the remaining 307 patients were screened for PMP22 point mutations. Nine point mutations were identified (8.5% of all mutations), eight of which were in exon 5, suggesting a point mutation hotspot for individuals with this condition. Sequencing analysis of PMP22 exon 5 should therefore be included as a routine diagnostic test for gene deletion-negative patients.