neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2022-3-4-172-177neurojour-78Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSИнтраневральная периневриома у детей и подростковIntraneral perineurioma in children and adolescentshttps://orcid.org/0000-0002-1004-992XДружининаЕвгения СергеевнаDruzhininaEvgeniya S.

Канд. мед. наук, доцент кафедры неврологии, нейрохирургии и медицинской генетики имени академика Л.О. Бадаляна педиатрического факультета ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России.

e-mail: naumovaes@gmail.com

MD, PhD, Associate Professor of the Department of Neurology, Neurosurgery and Medical Genetics of the Pediatric Faculty of the N.I. Pirogov Russian National Research Medical University. Moscow, 117997, Russian  Federation.

e-mail: naumovaes@gmail.com

naumovaes@gmail.comhttps://orcid.org/0000-0002-6244-0867ДружининД. С.DruzhininDmitry S.noemail@neicon.ruhttps://orcid.org/0000-0003-0103-7422ЗаваденкоН. Н.ZavadenkoNikolay N.noemail@neicon.ruФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical UniversityRussian FederationФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава РоссииРоссияYaroslavl State Medical UniversityRussian Federation20220302202334172177Copyright © Дружинина Е.С., Дружинин Д.С., Заваденко Н.Н., 20232023Дружинина Е.С., Дружинин Д.С., Заваденко Н.Н.Druzhinina E.S., Druzhinin D.S., Zavadenko N.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/78

Интранеральная периневриома (ИП) — это редкое и мало изученное доброкачественное новообразование периферических нервов у детей и лиц молодого возраста.  Клиническая картина обычно представлена медленно прогрессирующей мононейропатией, но могут вовлекаться и сплетения с преобладанием двигательного дефицита. Чаще всего поражается седалищный нерв и его ветви. Трудно диагностируется и требует большого объёма исследований для выявления и подтверждения диагноза. Сегодня для диагностики широко применяются такие методы нейровизуализации, как магнитно-резонансная томография (МРТ) нервных стволов и ультразвуковое исследование (УЗИ) периферических нервов, которые являются неинвазивными и позволяют опередить размер и локализацию образования. При МРТ и УЗИ периферических нервов выявляется фокальное веретеновидное увеличение нерва в пределах одного сегмента конечности с увеличением интенсивности МР-сигнала от ИП.  Эти новообразования считаются редкими, но последние достижения в МРТ и ультразвуковой диагностике позволяют выявлять их на ранней стадии. Также МРТ помогает отличить ИП от других образований периферических нервов. Подтверждение диагноза основано на гистологическом исследовании изменённого нервного ствола. На сегодняшний день отсутствует общепринятая стратегия ведения пациентов с ИП. Применяются как консервативные, так и хирургические методы лечения. Невролиз и декомпрессия нерва с ИП улучшают неврологический дефицит у половины пациентов. ИП не рецидивирует после оперативного лечения и не малигнизируется при длительном наблюдении за пациентом.

Участие авторов

Участие авторов:Дружинина Е.С. — обзор публикаций по теме статьи, написание текста рукописи;Дружинин Д.С. — написание текста, проверка критически важного интеллектуального содержания;Заваденко Н.Н. — написание текста статьи, окончательное утверждение для публикации рукописи;Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование проводилось без спонсорской поддержки. 

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. 

Поступила 02

Поступила 02.11.2022 Принята к печати 02.12.2022Опубликована  15.01.2023

Intraneral perineurioma (IP) is a rare and little-studied benign neoplasm of peripheral nerves in children and young adults.  The clinical picture is usually a slowly progressive mononeuropathy, but plexuses with a predominance of motor deficits may also be involved.  The sciatic nerve and its branches are most often affected.  It is difficult to diagnose and requires a large amount of research to identify and confirm the diagnosis. Today, non-invasive neuroimaging methods such as magnetic resonance imaging (MRI) of nerve trunks and ultrasound of peripheral nerves are widely used for diagnosis, which are and allow getting ahead of the size and location of the neoplasm. MRI and ultrasound of the peripheral nerves reveal a focal fusiform enlargement of the nerve within one segment of the limb with an increase in the intensity of the MR signal from the IP.  These neoplasms are considered rare, but recent advances in MRI and ultrasound diagnostics allow them to be detected at an early stage. MRI also helps distinguish IP from other peripheral nerve neoplasms.  Confirmation of the diagnosis is based on histological examination of the altered nerve trunk.  To date, there is no generally accepted strategy for the management of IP patients.  Both conservative and surgical treatments are used.  Neurolysis and nerve decompression improve neurological deficits in half of IP patients.  IP does not recur after surgical treatment and does not become malignant during long-term follow-up of the patient.

Contribution

Contribution:Druzhinina E.S. — review of reports on the topic а the article, writing the text;Druzhinin D.S. — writing the text, checking critical intellectual content;Zavadenko N.N. — writing the text.All co-authors are responsible for the  integrity of all parts of the manuscript and approval of its final version.

Acknowledgements

Acknowledgements. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: November 02, 2022Accepted:  December 2, 2022Published: January 15, 2023

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The authors declare that there are no conflicts of interest present.