Comparison On The Clinical Features Of Partial Neuromyelitis Optica And Multiple Sclerosis In Southwest China

Background:Some studies have indicated that the pathogenesis, pathologicalchanges， clinical manifestations, laboratory detections and MRI featuresof neuromyelitis optica (NMO) are different from those of multiplesclerosis (MS), though the previously published reports around the worldare inconsistent. It is essential to make a comparative study in southwestChina because so far no research has been based in this region.Objective:To compare the clinical features of NMO and MS patients and explorethe differences between the two.Methods:31NMO patients (including6high-risk NMO, HR-NMO) and34MSpatients who were first attacked or relapsed within one month wereenrolled and their medical histories reviewed. All of the patients underwentrelative biochemical, immunological and cerebrospinal fluid testing and brain MRI examination. NMO-IgG were tested by IndirectImmunofluorescence and the clinical conditions of the patients were scoredaccording to the Expanded Disability Status Scale (EDSS). All of thepatients underwent brain MRI examination. If neurologic examinationsuggested myeleterosis, a corresponding vertebral segments MRIexamination was then taken. The results of the above were subsequentlyanalyzed.Results:There significant differences were revealed in the gender proportion,EDSS score and the primary signs and symptoms of optic neuritis, bilateraloptic neuritis, severe optic neuritis, deep sensory disorders, Urinarydysfunction, Zonesthesia and Eye pain（P<0.05）. When we compared thelaboratory findings of the two groups, the frequency of oligoclonal bands(OCB) had significant differences（P<0.05）. The presence of NMO-IgGwas significantly higher in NMO patients than in MS patients (P<0.0001).Furthermore, the sensibility and specificity of serum NMO-IgG were77.42%and94.12%respectively in the NMO patients. There weresignificant differences between the two groups in segments of spinal cordinjury (P<0.0001) and the proportion of patients who had more than threesegments of spinal cord injury (P<0.0001). The proportion of patients whohad intracranial injury and intracranial lesions between the two groups hadsignificant differences（P<0.0001）. Conclusion:NMO is a different demyelinating disease than MS. There weresignificant differences between patients with NMO and MS in thepathogenesis, pathological changes, onset types, clinical manifestation,imaging findings and experimental indexes, although some similaritieswere noted as well. The differentiation is needed in order to avoid misseddiagnosis, misdiagnoses and withholding treatment.