Related Neurophysiological Study On Neuropathy Of Optic Neuromyelitis Spectrum

Objective To study the neuroelectrophysiological changes of peripheral neuropathies in optic neuromyelitis spectrum diseases(NMOSD)and to explore its possible pathogenesis in combination with related literatures.Methods From January 2015 to August 2017,56 patients diagnosed as patients with NMOSD in the Department of Neurology of Anhui Provincial Hospital met the internationally accepted diagnostic criteria of adult NMOSD in 2015 and excluded the patients with peripheral nerve damage Of patients with related diseases,such as diabetes,cervical spondylosis,connective tissue disease,alcohol abuse,vitamin B6 deficiency,hypothyroidism and so on.A total of 43 women and 13 males were enrolled in this study.Clinical data,laboratory data and imaging data were collected from all the study subjects including 43 males and 13 females,with a ratio of 1: 3.3.They were18-78 years old(mean 46.07±16.46 years)Patients(NMOSD group)and 20 healthy controls(normal control group)were examined by EMG.NMOSDgroup: There were15 patients in the NMOSD group,including 5 males and 10 females,aged 18-66 years,with an average of(47.73 ± 15.70)years;Normal control group: a total of 20 cases,including 10 males and 10 females,aged 20-60 years,with an average(45 ± 14.21)years;There was no significant difference between the two groups in gender and age,which was not comparable.Participants were voluntary subjects,and signed informed consent.Patients in the study group were improved lumbar puncture,AQP4 antibody test,some patients perfect MOG and MBP test,EMD group and normal control group EMG examination,including NCV,F wave,H reflex.Results 1.There was no significant difference in gender and age between the NMOSD group and the normal control group.2.In the NMOSD group,10 cases(66.7%)had abnormal EMG examination,which was mainly characterized by slowing of motor or sensory nerve conduction velocity,decreasing amplitude,decreasing incidence of F wave and prolonging latency of H reflex.3.Compared with the normal control group,the motor nerve conduction velocity in the tibial nerve and the common peroneal nerve of the NMOSD group was significantly decreased(all P <0.01);the latency of the distal and proximal segments of the median nerve and the distal latency of the tibial nerve were significantly increased(P <0.05);The tibial nerve and peroneal nerve motor distal / proximal amplitude were significantly reduced(all P <0.01).4.Compared with the normal control group,sensory nerve conduction velocity of the ulnar nerve,median nerve and sural nerve of the NMOSD group was significantly slowed down(P <0.01),and sensory nerve latency of the sural nerve increased significantly(P <0.01),The median nerve,sural nerve sensory nerve amplitude was significantly reduced(all P <0.01).5.There was no significant difference in H reflex latency(26.22±10.10)between NMOSD group and normal control group(24.36 ± 0.63)(P> 0.05).Conclusion NMOSD is a demyelinating disease that mainly damages the central nervous system.Some patients may have peripheral nervous system involvement.Nerve electrophysiological examination mainly shows that the motor or sensory nerve conduction velocity is slowed,the amplitude is decreased,the incidence of F wave is decreased,and H reflex latency.Neuroelectrophysiology is currently the ideal method to evaluate the degree of peripheral nerve damage.