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多发性硬化的神经眼科学

The neuro-ophthalmology of multiple sclerosis.

作者信息

Frohman Elliot M, Frohman Teresa C, Zee David S, McColl Roderick, Galetta Steven

机构信息

Department of Neurology, University of Texas Southwestern Medical Center at Dallas, TX 75235, USA.

出版信息

Lancet Neurol. 2005 Feb;4(2):111-21. doi: 10.1016/S1474-4422(05)00992-0.

Abstract

Multiple sclerosis (MS) is the most common disabling neurological disease in young people. Most CNS lesions involve neuroanatomically non-eloquent zones that often do not result in symptomatic complaints. By contrast, tissue-injury mechanisms involving inflammatory demyelination can involve more eloquent sites, such as the optic nerve and brainstem, which can correspondingly produce the development of well recognised syndromes such as optic neuritis and internuclear ophthalmoplegia, respectively. In this review we discuss the broad landscape of abnormalities that affect the afferent visual system and the ocular motor apparatus, and emphasise relevant features, the recognition and treatment of which are of importance to general neurological practice. The commonness of visual sensory and eye movement abnormalities in MS highlights the importance of understanding the principles addressed in this review.

摘要

多发性硬化症(MS)是年轻人中最常见的致残性神经疾病。大多数中枢神经系统病变累及神经解剖学上无明确功能的区域,这些区域通常不会导致有症状的主诉。相比之下,涉及炎性脱髓鞘的组织损伤机制可能累及更明确的部位,如视神经和脑干,这可能分别相应地导致诸如视神经炎和核间性眼肌麻痹等公认综合征的发生。在本综述中,我们讨论了影响传入视觉系统和眼球运动装置的广泛异常情况,并强调了相关特征,对这些特征的识别和治疗对一般神经科实践具有重要意义。MS中视觉感觉和眼球运动异常的普遍性凸显了理解本综述中所阐述原则的重要性。

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