Dimitri D
Fédération de Neurologie, Prs. Y. Agid et O. Lyon-Caen, Centre Hospitalier Universitaire Pitié-Salpêtrière, 47, Boulevard de l'Hôpital, 75013 Paris.
Rev Neurol (Paris). 2001 Sep;157(8-9 Pt 2):914-28.
This paper reviews the validity of clinical diagnostic criteria and clinical course classification. Validation based on the pathological verification is not available. MS diagnosis remains clinical based on the objective demonstration of dissemination of lesions suggestive of MS in both time and space. Also clinical features are not specific and sensitive enough. MRI is primordial. MRI diagnosis criteria are discussed. Clinical course classification is difficult in regard to the extreme heterogeneity of the disease. Classical distinction between recurrent and progressive forms is reviewed from natural history studies and recent MRI and pathological findings. Recent studies focus on presentation including monosymptomatic disease and primary progressive forms.
本文回顾了临床诊断标准和临床病程分类的有效性。基于病理验证的有效性尚不可用。多发性硬化症(MS)的诊断仍然基于临床,即客观证明病变在时间和空间上的播散提示为MS。此外,临床特征的特异性和敏感性还不够。磁共振成像(MRI)至关重要。文中讨论了MRI诊断标准。鉴于该疾病的极端异质性,临床病程分类很困难。从自然史研究以及最近的MRI和病理研究结果中回顾了复发型和进展型之间的经典区分。最近的研究聚焦于包括单症状疾病和原发进展型在内的表现形式。