Comparison And Analysis On The Clinical Features Of Multiple Sclerosis And Neuromyelitis Optica

Objective To compare and analyse the clinical features of multiple sclerosis(MS) and neuromyelitis optica(NMO), and providing assistance for differential diagnose.Methods Retrospectively review the 108 patients diagnosed as MS and 45 patients diagnosed as NMO in General Hospital of Ningxia Medical University from Janauary 2000 through September 2015, and analysize the clinical features. The clinical data including sex, age, initial events, imaging features, laboratory examination, and evoked potential.Result 1.The comparison of general: male to feamale ratio is 1:3.70 of MS and 1:4.63 of NMO; the average first onset age of MS is 36.52±13.41 years, NMO is 35.29±13.96 years; 2.Features of clinical course:more than half patients of MS or NMO with relapsing forms(≥2 times clinical seizures); 3.Comparison of the first clinical symptoms: MS and NMO have same level in Limb weakness(P=0.055) and sensory disturbances(P=0.713). The rate of vision disorder(P=0.001), sphincter disorders(P=0.002), and eyeball orbital pain(P=0.010) of NMO are significantly higher than MS. The rate of headache(P=0.024), dizzy(P=0.031), and ataxia(P=0.018) of MS are higher than NMO. 4.Laboratory comparison: The rate of CSF leukocyte count increased(P=0.018) of NMO is higher than NMO(60.00% VS 39.08%, P=0.036). Oligoclonal bands(OB) positive rate(P=0.002) of MS patients was significantly higher than NMO(52.63% VS 13.33%, P=0.017). The abnormal rate of the CSF protein concentration(P=0.473), CSF sugar concentration(P=0.168), CSF chlorine monoxide concentration(P=0.386), CSF-IgG concentration(P=0.370) of NMO had no statistical difference between MS and NMO. 5.Comparison of imaging features: MS patients had brain MRI lesions was significantly higher than the rate of NMO(85.05% VS 45.24%, P=0.000). MS lesions in the head involving the lateral ventricle(60.44%), semioval center(52.75%), and brainstem(32.97%) are more common. While NMO lesions located in the head near the lateral ventricle(31.58%), thalamus(31.58%), semioval center(26.32%) are more common. The presence of spinal cord lesions in NMO patients with longitudinally extensive transverse myelitis(LETM)(>3segments) ratio was significantly higher than that of MS(P≤0.05).Conclusion 1.Sensory disturbances is the most common first clinical symptoms in MS(79.63%). Limb weakness is the most common first clinical symptoms in NMO(86.67%). Visual disorder in NMO patients was significantly higher than in patients with MS. 2.CSF leukocyte count and OB may be play a very important role in the differential diagnosis. 3.The average length of spinal cord lesions in MS is 3 and in NMO is 5.5.