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脱髓鞘疾病的鉴别诊断与诊断算法

Differential diagnosis and diagnostic algorithm of demyelinating diseases.

作者信息

Dezmalj-Grbelja Lidija, Cović-Negovetić Ruzica, Demarin Vida

机构信息

University Department of Neurology, Reference Center for Neurovascular Disorders, Ministry of Health and Social Welfare of the Republic of Croatia, Sestre milosrdnice University Hospital, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2009 Sep;48(3):345-8.

Abstract

Demyelinating diseases of the central nervous system include a wide spectrum of different disorders that may resemble multiple sclerosis (MS). The diagnosis of MS is based on typical clinical and paraclinical criteria. The simplified McDonald's criteria, which combine clinical picture, NMR findings, CSF analysis and visual evoked potentials, are appropriate for daily neurologic routine. If some of these criteria are atypical, diagnostic algorithm should be extended to some other procedures to exclude other diseases that can mimic MS not only in symptoms, signs or course of the disease but also in laboratory findings. In such a case, an alternative, better explanation for the clinical manifestations should be considered and performing specific tests is helpful to exclude alternative diagnoses.

摘要

中枢神经系统脱髓鞘疾病包括一系列可能类似多发性硬化症(MS)的不同病症。MS的诊断基于典型的临床和辅助临床标准。简化的麦克唐纳标准结合了临床表现、核磁共振成像结果、脑脊液分析和视觉诱发电位,适用于日常神经科诊疗。如果这些标准中的一些不典型,诊断算法应扩展到其他一些程序,以排除不仅在症状、体征或病程上,而且在实验室检查结果上都可能模仿MS的其他疾病。在这种情况下,应考虑对临床表现的另一种更好的解释,进行特定检查有助于排除其他诊断。

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