Scholl G B, Song H S, Wray S H
Department of Neurology, Massachusetts General Hospital, Boston 02114.
Ann Neurol. 1991 Aug;30(2):180-4. doi: 10.1002/ana.410300209.
Eighty-one patients with a first attack of isolated optic neuritis, 40 with Uhthoff's symptom (Group 1) and 41 without (Group 2), were studied. All had a neurovisual examination, 74 of 81 patients had the pattern visual evoked potential recorded at rest, and 43 had magnetic resonance imaging brain scans. The pattern visual evoked potential P100 latency was prolonged, Group 1 with a mean of 136 +/- 19 msec. Group 2 with a mean of 131 +/- 19 msec (control subjects, 102 +/- 5 msec; n = 84), and the P100 amplitude was reduced, without significant difference between the groups. Abnormal magnetic resonance imaging scans were present in significantly more patients in Group 1 (p less than 0.025). Treatment of optic neuritis with corticosteroids had no effect on the evolution or duration of Uhthoff's symptom. Overall, 35 of 81 (43%) patients, followed for a mean of 3.5 years, developed multiple sclerosis. The incidence was significantly greater in Group 1 (p less than 0.01). Uhthoff's symptom also correlated with a higher incidence of recurrent optic neuritis. We conclude that Uhthoff's symptom is a prognostic indicator for the early development of multiple sclerosis.
对81例首次发作孤立性视神经炎的患者进行了研究，其中40例有Uhthoff症状（第1组），41例无Uhthoff症状（第2组）。所有患者均接受了神经视觉检查，81例患者中有74例在静息状态下记录了图形视觉诱发电位，43例进行了脑部磁共振成像扫描。图形视觉诱发电位P100潜伏期延长，第1组平均为136±19毫秒，第2组平均为131±19毫秒（对照组为102±5毫秒；n = 84），且P100波幅降低，两组间无显著差异。第1组中磁共振成像扫描异常的患者明显更多（p＜0.025）。用皮质类固醇治疗视神经炎对Uhthoff症状的演变或持续时间没有影响。总体而言，81例患者中有35例（43%）平均随访3.5年，发展为多发性硬化症。第1组的发病率明显更高（p＜0.01）。Uhthoff症状也与复发性视神经炎的较高发病率相关。我们得出结论，Uhthoff症状是多发性硬化症早期发展的一个预后指标。
