多发性硬化的临床诊断张星虎.pdfVIP

中国现代神经疾病杂志 年 月第 卷第 期 2 ·122 · 2012 4 12 2 Chin J Contemp Neurol Neurosurg, April 2012, Vol. 12, No. 专题讲座 · · 多发性硬化的临床诊断 张星虎 【摘要】 多发性硬化是中枢神经系统炎性脱髓鞘疾病。目前病因未阐明，发病机制与自身免疫性 反应有关。临床表现的显著特点为时间多发性（多次发作）和空间多发性（多个病变部位）。常用辅助检 查手段包括头部或脊髓MRI 、脑脊液免疫学、诱发电位等。最新的诊断标准为2010 年McDonald 标准。 目前认为，多发性硬化与视神经脊髓炎在临床、病理、影像等方面不同，由于该病临床表现的多样性及缺 乏特异性生物学诊断指标，其诊断仍然是临床医师面临的最大难题之一。 【关键词】 多发性硬化； 视神经脊髓炎； 诊断； 诊断，鉴别； 综述 ： DOI 10.3969/j.issn.1672⁃6731.2012.02.005 Clinicaldiagnosisofmultiplesclerosis ZHANG Xing⁃hu Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China (Email:xhzhtiantan@) 【 】 Abstract Multiple sclerosis (MS) is an inflammatory demyelinating disease in central nervous system. The etiology is still unknown. The pathogenesis may be related to autoimmune response. Clinical features are dissemination in time (multiple attacks) and dissemination in space (multifocal episode). The common used examinations including brain or spinal MRI, CSF analysis and evoked potentials. The latest diagnostic criteria is McDonald criteria published in 2010. It is now accepted that neuromyelitis optica (NMO) is different from MS in clinical, pathology, imaging and so on. Due to the diversity in clinical manifestation and the lack of specific biological parameters, the diagnosis of multiple sclerosis is still challenging. 【 】 Key words Multiple sclerosis; Neuromyelitis optica; Diagnosis; Diagnosis, differential; Review 多发性硬化（ ）是中枢神经系统炎性脱髓鞘 眼）、复视、共济失调、肢体麻木无力、大小便障碍 MS 疾病。目前病因尚未阐明，发病机制与自身免疫反 等。