诊断为脊髓型多发性硬化的脊髓疾病附68例临床分析  

Spinal cord diseases diagnosed as spinal cord multiple sclerosis:clinical analysis of 68 cases

作　　者：录海斌[1,2] 李振新[2] 俞海[2] 吕传真[2] 

机构地区：[1]郑州市第一人民医院神经内科,河南郑州450004 [2]上海市复旦大学附属华山医院神经科,上海200040

出　　处：《中风与神经疾病杂志》2013年第2期161-164,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的应用新的多发性硬化和视神经脊髓炎诊断标准,回顾分析以往被诊断为"脊髓型多发性硬化"的病例,探讨与主要累及脊髓的脱髓鞘疾病相鉴别的重要疾病类型。方法应用2010年新修订的McDonald多发性硬化诊断标准,以及2006年Wingerchuk视神经脊髓炎的诊断标准,回顾分析我院1994年～2012年之间曾被诊断为"脊髓型多发性硬化"的患者68例,并进行随访。结果仅17.65%的患者完全符合McDonald标准,多数脊髓型多发性硬化患者最终转变为视神经脊髓炎,其它疾病如脊髓血管病和系统性自身免疫病也易被误诊为脊髓型多发性硬化。结论对于孤立的脊髓综合征应该按照一定的诊疗规范进行诊断、鉴别和随访,不建议再使用脊髓型多发性硬化的名称。Objective To analyze the cases diagnosed as spinal cord multiple sclerosis with the new diagnostic crite- ria of multiple sclerosis and optic myelitis, and explore the different types of demyetinating diseases related to the spinal cord. Methods To analyze the 68 cases in the hospital from 1994 to 2012 who had been diagnosed as ＂multiple sclerosis＂ Results With following up, we found that only 17.65% of the cases can comply with the mcdonald criterion completely, but most of them were actually afflicted by optic myelitis. The others such as spinal cord diseases and systemic autoimmune disease were also easily misdiagnosed as multiple sclerosis. Conclusion We should diagnose, identify and follow-up visit the isolated spinal cord syndrome according to certain clinical guidelines. It is suggested that the term of spinal cord multiple sclerosis should no longer be used.

关 键 词：多发性硬化 视神经脊髓炎 脊髓血管病 鉴别诊断 

分 类 号：R744.51[医药卫生—神经病学与精神病学]