[Letter to the editor on classification and terminology of paraneoplastic syndrome of peripheral nervous system in small cell carcinoma of the lungs].
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This review article on the degeneration and regeneration of peripheral nerve fibers was presented as a Plenary Lecture at the 2001 meeting of the Peripheral Nerve Society. It is accompanied by a reprint of Augustus Waller's 1850 article, which gave rise to the pathologic process termed Wallerian degeneration. This review is focused on the role of neuroinflammation in Wallerian degeneration and how immune mediators contribute to both axonal degeneration and regeneration. Similarities and differences between the PNS and CNS in terms of inflammation and microglial activation after nerve injury are discussed, and point towards progress in understanding the failure of nerve fiber regeneration in the CNS.
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Twenty-seven cases of panarteritis nodosa (PAN) with peripheral neuropathy are reported. Diagnosis was based on pathological criteria of necrotizing vasculitis in 20 patients (group I) and on clinical, biological and sometimes arteriographic data in 7 (group II). The 27 patients (18 women and 9 men), aged between 30 and 78 years (mean: 53.4 years), presented either a mono- or multineuropathy (8 cases), a polyneuropathy (17 cases), or sensory symptoms (2 cases). A neuropathy was the initial feature of the PAN in 15 cases. The CSF, examined in 16 cases, was always normal, and results of electrophysiological investigations constantly suggested the presence of an axonal neuropathy with normal motor nerve conduction rates. Other signs of PAN included fever (81 p. 100 cases) and loss of weight (74 p. 100). The ESR was increased in 70 p. 100 cases and hypereosinophilia was present in 33 p. 100. Quantitative pathology in 13 cases from group I revealed typical findings, and associated microvasculitis in 4 cases. The outcome was fatal in 13 cases while 12 recovered and have been followed up for from 1 to 14 years.