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摘要目的:定义神经问题可能发生在硅胶乳房植入手术的女性。背景:硅胶乳房植入物之间的联系(sbi)和某些疾病障碍已经讨论了自1980年代以来。最近的不受控制的情况下系列报道神经问题被认为是与印度国家银行联系在一起。设计:病例分析基于回顾医疗记录的数据分析131名女性被诊断为神经问题与印度国家银行。方法:从医疗记录和分析提取的数据包括神经症状,神经系统检查发现,各种各样的实验室研究。症状,检查发现,分析了实验室研究使用方法会故意overreport假阳性结果为了消除可能的偏见的指控。最后,之前诊断由评估医生和被认为是与印度国家银行也被记录下来。还为一个独立评估替代使用标准接受医疗诊断和神经社区并不一定接受印度国家银行之间的因果联系和他们所谓的并发症。结果:神经症状经常被支持,包括疲劳(82%)、记忆丧失和其他认知障碍(76%)和广义肌痛(66%)。尽管多次投诉,但多数患者(66%)有正常的神经系统检查。 Findings reported as abnormal were mild and usually subjective, including sensory abnormalities in 23%, mental status abnormalities in 13%, and reflex changes in 8%. No pattern of laboratory abnormalities was seen, either in combination or in attempts to correlate them with the clinical situation. Laboratory studies appeared to be random without an attempt to confirm or correlate with a particular diagnosis. Diagnoses by physicians endorsing the concept that SBIs cause illness included ``human adjuvant disease'' in all cases, memory loss and other cognitive impairment (``silicone encephalopathy'') and/or ``atypical neurologic disease syndrome'' in 73%, ``atypical multiple sclerosis-like syndrome'' in 8%, chronic inflammatory demyelinating polyneuropathy in 23%, and some other type of peripheral neuropathy in 18%. There was no coherence in making these diagnoses; the presence of any symptoms in these women was sufficient to make these diagnoses. Alternatively, after review of the data, no neurologic diagnosis could be made in 82%. Neurologic symptoms could be explained in some cases by depression (n equals 16), fibromyalgia (n equals 9), radiculopathy (n equals 7), anxiety disorders (n equals 4), multiple sclerosis (n equals 4), multifocal motor neuropathy (n equals 1), carpal tunnel syndrome (n equals 1), dermatomyositis (n equals 1), and other psychiatric disorders (n equals 3). Conclusions: There is no evidence that SBIs are causally related to the development of any neurologic diseases. Methods of diagnosis that have been used to make the diagnosis of neurologic disease in these patients are contrary to standards accepted by the neurologic community. Several possible explanations exist for the neurologic and other symptoms in women with breast implants.
首页神经学1996年46 308 - 314
- 版权1996年Advanster通信公司。
