Clinical Characteristics Analysis Of Neuromyelitis Optica Spectrum Disorders And Multiple Sclerosis

Objective To compare the clinical characteristics of patients with neuromyelitis optica spectrum disorders and multiple sclerosis and to assess the prognosis of both so that clinicians can make early diagnosis and treatment to improve patient prognosis.Methods 1.Collecting from January 2018 to January 2022,Ningxia medical university general hospital and Cardiocerebral Vascular Disease Hospital first diagnosed as NMOSD and MS patients clinical data(general data,past history,first clinical symptoms,physical examination,laboratory examination,imaging examination,three induced potentials,etc.);2.Patients were followed up for relapses,residual symptoms and medication intake during remission;3.Patients were scored on the Expanded Disability Status Scale on admission,discharge and 1 year after discharge;4.The clinical characteristics of the two diseases were summarized and their results were statistically analyzed.Results 1.The proportion of female NMOSD and MS women was 81(86.17%)and 20(68.97%),respectively,showing a statistically significant difference(p=0.035).The mean age of onset of NMOSD and MS was 45.61±15.69 and 39.62±14.91 years,respectively,and the age of onset of NMOSD was older,but the difference between the two groups was not statistically significant(p>0.05).NMOSD was shorter than MS in terms of time taken to confirm the diagnosis and duration of disease,with a statistically significant difference between the two groups(p<0.05).Both NMOSD and MS had a predominantly prodromal infection as a first-onset trigger,but the difference between the two groups was not statistically significant(p>0.05)2.NMOSD and MS combined with autoimmune diseases were 19 cases(20.21%)and 1case(3.45%),respectively,and the difference was statistically significant(p=0.042).Among the first symptoms of NMOSD and MS,the differences between the two groups were statistically significant in sensory impairment(p=0.035),motor impairment(p=0.042),visual impairment(p=0.048)and vesicorectal dysfunction(p<0.001).The number of NMOSD admissions with muscle strength grade 0～3 was 40(42.55%)and MS was 4(13.79%),with a statistically significant difference between the two groups(p=0.005).NMOSD was higher than MS in terms of acute EDSS score,EDSS score 1 year after discharge,relapse rate within 1year of discharge,presence of residual symptoms and use of immunosuppressive drugs,but the two groups were statistically significant only in terms of acute EDSS score(p<0.05).3.NMOSD was more common than MS in terms of elevated cerebrospinal fluid leukocytes and elevated protein levels,with statistically significant differences between the two groups(p<0.05).There was no statistically significant difference in cerebrospinal fluid pressure,glucose and chloride levels between the two groups(p>0.05).In serum and cerebrospinal fluid examination,the rate of AQP4 antibody positivity was higher in NMOSD patients and OCB positivity was higher in MS patients,and the difference between the two groups was statistically significant(p<0.05).NMOSD was more common than MS in terms of positive anti-SSA/SSB antibodies and reduced T3 and FT3 levels,with statistically significant differences between the two groups(p<0.05).4.MS was more prone to cranial MRI signal abnormalities,with statistically significant differences in involvement of the subcortex(p=0.008),centrum semiovale(p=0.005)and parietal ventricles(p<0.001).NMOSD was more prone to spinal MRI signal abnormalities,with statistically significant differences in the involvement of cervical segments(p=0.038),thoracic segments(p=0.001),cervicothoracic segments(p=0.006)and the number of involved segments ≥3(p<0.001).NMOSD was more likely to have visual evoked potential abnormalities,and the difference between the two groups was statistically significant(p<0.05).Conclusion 1.Compared with MS,NMOSD has an older age of onset,a higher proportion of women,a higher rate of recurrence and disability,and is more likely to have abnormal visual evoked potentials.2.NMOSD is more likely to have spinal cord MRI signal abnormalities,with long-segment spinal cord injuries being more common,and MS is more likely to have cranial MRI signal abnormalities,with the abnormalities mostly located in the subcortical,centrum semiovale and parietal ventricles.