Objective To describe the clinical characteristics,treatment response and prognosis of Lewis-Sumner syndrome(LSS).Methods The clinical data of 6 cases of LSS including features of clinical presentation,laboratory test,lumbosacral and cervical MRI,sensory nerve biopsy,electrophysiology and treatments were analyzed retrospec-tively.The follow-up study was conducted by telephone.Results The characteristic presentation of LSS was chronic sensorimotor neuropathy involving motor and sensory loss in discrete peripheral nerve distributions instead of a generalized stocking or glove pattern.Cranial nerve could also be involved in some cases.CSF protein was normal or mildly ele-vated.Spinal MRI showed increased cervical nerve root and brachial plexus swelling.Sural nerve biopsies showed de-myelinating characteristics.The presence of multifocal persistent conduction blocks was the most significant feature of electrophysiological study.Corticosteroids were effective for LSS.Conclusions LSS typically presents as a chronic sens-orimotor multiple mononeuropathy and can be evolved into a more diffuse neuropathy at advance stage of the disease.Asymmetry is always a striking characteristic.LSS is well responded to corticosteroids.

<正>一、慢性炎性脱髓鞘性多发性神经根神经病(chronic inflammatory demyelinating polyradiculoneuropathy,CIDP)CIDP是一种累及神经根和周围神经的免疫介导性疾病,其典型临床表现为四肢对称性麻木无力,运动症状重于感觉症状,肢体近端与远端均受累,病情进展超过2个月,呈慢性进展或复发-缓解的病程特点,脑脊液检查呈蛋白-细胞分离现象,神经电

本指南对预测一个人发生首发卒中的风险的方案进行了评估.首发卒中的危险因素或者危险标识根据是否能被干预分类(不可干预的、可干预的和潜在可干预的),或者根据证据强度分类(证据充分和证据不充分).不可干预的险因素包括年龄,性别、低出生体重、种族和遗传易感性.证据充分并可干预的危险因素包括高血压、暴露于吸烟环境、糖尿病、心房颤动和某些其他心脏疾病、血脂异常,颈动脉狭窄,镰状细胞病、绝经后激素治疗、饮食不当、缺乏运动,肥胖和身体脂肪分布.证据不充分或者潜在可干预的危险因素包括代谢综合征、酗酒、滥用药物、口服避孕药、睡眠呼吸紊乱、偏头痛、高同型半胱氨酸血症,高脂蛋白(a)、高凝状态、炎症和感染.本指南还对使用阿司匹林预防首次卒中的数据进行了回顾,针对各种危险因素,提出了减少卒中风险可采取的策略.本指南综述了各种已经明确和近期明确的危险因素的证据,对2006年的指南进行了完整的修订.新版指南涉及的范围更加广泛.2006年指南着重于缺血性卒中的预防,由于危险因素和预防措施的重叠,本指南新加了出血性卒中的预防,并将重点放在以患者为本的个体化卒中预防.

(上接第8期第670页) 2 证据充分的可干预危险因素 2.1 高血压高血压既是脑梗死的危险因素,也是脑出血(intracerebral hemorrhage, ICH)重要的危险因素.血压和卒中之间存在强烈的、连续的、分级别的、一致的和独立的相关性,而且是有预测意义以及病因学意义的.