Detection of the demylination changes in patients with chronic viral hepatitis B by the evaluation of the nerve conduction study

الملخص EN

Background : Segmental demyelination occurs when there is dysfunction or death of the Schwann cell or damage to the myelin sheath Segmental demyelination with slowed nerve conduction, of these, wallerian and axonal degeneration cause denervation and reduce the amplitude of compound action potential, whereas demyelination slows the nerve conduction with or without conduction block.

Infection with HBV is one of the most common viral diseases affecting man ; extra hepatic symptoms may result from deposition of antigen-antibody complexes formed when these particles are neutralized by anti-HBeAg antibodies.

The pathogenesis of these extra hepatic disorders has not been fully elucidated but likely involves an aberrant immunologic response to extra hepatic viral proteins.

The neurological manifestations of chronic hepatitis B viral are most often a peripheral sensory neuropathy characterized by numbness, burning and sensation of “ pins and needles ” peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex. Objectives : to assess the peripheral nerves abnormalities and detected the segmental demyelination in chronic viral hepatitis B patients by using Nerve conduction study and to evaluate the relation between the sensory and motor peripheral neuropathy on different type of chronic viral hepatitis B Methods: This study was conducted at the neurophysiology unit Gazy AL-Harriry surgical specialties teaching hospital, thirty chronic viral hepatitis B patients included in these studies without treatment compare with Twenty-seven of the normal healthy subjects, by the evaluation of nerve conduction studies.

Results In our electrophysiological studies, sensory lesions were recorded in 17 (56.7 %) out of 30 CVHB patients, while motor nerve lesions were recorded in 1 (3.33 %) out of 30 CVHB patients.

The mononeuropathical changes where recorded on 8 (26.67 %) out of 30 CVHB patients Conclusion : the sensory and motor nerves conduction measurements were frequently impaired in CVHB patients.