| Objective To summary clinical features of multiple sclerosis (MS) in guangxi and to evaluate the value of cerebrospinal fluid examination ,electrophysiological examination and imaging tests on the diagnosis of MS and its treatment as well as prognosis.Methods We had collected clinical data in 254 patiens with multiple sclerosis.clinical manifestations, cerebrospinal fluid, imaging, electrophysiology and treatment were analyzed retrospectively.Results⑴Among 254MS cases, 96 in male and 158 in female, The ratios between male and female was 1:1.65. The first onset age was from 8 to 71 years old (Average 36.29±11.31 years old), The peak age at disease onset varied from 20 to 40 years old, accounting for 54.72%.⑵Before illness,34.25% cases had evoking factors in which 20.87% were relevant to infections, 12.99% cases had autoimmune diseases,79.13% had acute and subacute courses and 50.79 % had relapses.⑶clinical manifestations were complex and diverse, limb weakness (44.09%) was the most common initial symptoms, followed by numbness of numbness (39.76%), and visual impairment (19.69%); Limb weakness (77.9%), sensory disturbances (58.6%), visual impairment (39.4%) were the most common symptoms and signs of MS patients, 46.85% cases had seizure symptoms in which the cramps (33.6 %), paroxysmal paresthesia (24.36%), epilepsy (22.7%) and Itching(16.8%) were relatively common; 28.7% of patients had mental disorders and cognitive impairment. 9.4% of patients had peripheral nervous system damage.⑷The location of the lesions have 119 cases(46.85%) in cerebrum, 112 cases(44.09%) in spinal cord, 101 cases (39.76%)in brainstem, 94 cases (37.01%) in optic nerve,40 cases (15.75%) in cerebellum.⑸90.8% patients showed abnormal MRI, In cranial MRI periventricular, semi-oval centers, and brain stem were mostly involved, In spinal cord MRI cervical and thoracic cord were prominent.⑹SEP abnormality rate (80.2%) was the highest, Secondly, they were VEP abnormality rate (76.8%), BAEP abnormality rate (72.4%), 15.1% patients with abnormal VEP, 38.2% patients with abnormal BAEP and 7.7% patients with abnormal SEP were asymptomatic.⑺In 201 cases with corticosteroids pulse therapy, 157 patients had improvement of symptoms and signs, with its efficiency 78.11%.Conclusion⑴MS onset age of this group mainly invades young and middle-aged people, with a higher ratio in female than in male. MS was found mostly acute or subacute in onset. The location most frequently involved was cerebrum, followed by the spinal cord, brainstem, optic nerve, cerebellum.⑵The first symptoms of MS were various and complicated, mainly showed limb weakness, numbness, and visual impairment. Paroxysmal symptoms (46.85%) were common, and were partly the initial symptoms of MS. We should deepen the recognition to MS.⑶There are diverse and complex clinical manifestations in patients with MS,limb weakness, sensory disturbances and visual impairment were found the commonest symptoms, but the spirit of cognitive impairment (28.7%) and peripheral nervous system damage (9.4%) was also not uncommon, clinicians should cause attention.⑷Combined use of evoked potentials and MRI findings may be helpful for discovering subclinical lesions in CNS, which can improve early diagnosis and reduce misdiagnosis and missed diagnosis.⑸The administration of glucocorticoid is effective. |
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