| Multiple sclerosis (MS) has become a great challenge in neurology because of its cilinical and spacious variety. The purpose of this study is to analyse the clinical characters, the diagnosis on the early stage and the treatment of MS. We tried to conclude some useful information for clinical doctors. We retrospectively studied the clinical information, including clinical manifestation, images and the treatment of 164 MS patients from 1993-2003. We summarized the clinical and imaging characters of 164 multiple sclerosis cases in Northern China and analysed the treatment of these cases. There were 93 clinical confirmed MS and 71 clinical supported definite MS, which totally included 48 male and 116 female. The onset age ranged from 4.5 months to 66 years old. The children type (<15 years old) was 9.8%. The onset symptoms were mostly acute (21.3%) or subacute (51.8%) in onset and usually involved with the inducement, which was in turn the infection (23.8%), fever (5.5%) and so on. Relapsing-remitting MS was 58.5%; secondary-remitting MS was 19.5%; progressing-progressing MS was 13.4% and primary-progressing MS was 5.5%. Limb weakness (60 cases, 36.6%), sensory impairment (42 cases, 25.6%) and visual disturbance (37 cases, 22.6% ) were found as the commonest onset symptoms. Sensory impairment symptoms were often found ( 55.5% ) , especially in the form of hypopselaphesia, hypalgesia and even analgesia. And like the other domestic reports, the visiual symptoms were found in more than half cases (51.2%). The most valuable laboratory is MRI, which showed multiple white matter lesions in 93.5% brain MRI of patients and 87.5% spine MRI. The major lesions usually located in the periventriclular white matter, corona radiata, the basal ganglia and cerebral stem area. In conclusion, many parts of nerve system such as optic nerve, cerebral stem, cerebellum, hemisphere and spine could be involved in MS lesions. Thus the clinical symptoms of MS are presented variously, leading to lots of difficulty in diagnosis on the early stage. Within this study, we summarized 3 special cases. In this 164 cases, 34 cases were diagnosed "acute demyelinating cerebral disease". In the past, the relation of MS and "acute demyelinating cerebral disease "was always controversial. However, the current scholars prefer to the theory that the "acute demyelinating cerebral disease"is the cerebral type of MS. Only because of the repetitive character of MS, the first onset of MS is usually called "acute demylinating cerebral disease". For the reasons above, we re-analysed these 34 cases independently. And we found the sexual rate, the onset age are both similar to those of 164 cases. While more cases likely happened acutely or subacutely (91.2%), mostly presenting psychosis (29.4%), aphasiac (11.8%) and unconsciousness (23.5%). On the contrary, only 35.3% cases presented cranial nerves damaged. The mortality of 34 cases reached 14.7%. The adrenocorticotro could obviously eliminate the MS clinical symptoms(P<0.05). However there was no significant discrimination between low-dose group and large-dose group. According to the results above, we got the conclusion as below: The characters of MS in this study are â‘ that the onset age of MS in this study is younger, the course is shorter; â‘¡that cranial nerves such as optical nerve are more likely to be damaged, while the cerebellum is seldom involved; â‘¢that...
|
PDF Full Text Request