Warabi Yoko
Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai Fuchu, Tokyo 183-0042, Japan.
ISRN Neurol. 2011;2011:904706. doi: 10.5402/2011/904706. Epub 2011 Sep 6.
For the purpose of predicting multiple sclerosis (MS) and neuromyelitis optica (NMO) relapses in Japanese population, we evaluated the localization and age of each demyelinating attack. We retrospectively analyzed the 78 medical records of Japanese MS and NMO patients. Then we identified 49 cases of relapsing-remitting-type patients and defined each of 116 demyelinating attacks. NMO had an older age at onset than MS, although the initial symptoms cannot predict the clinical phenotypes. Only 21.3% of demyelinating attacks were localized in the cerebrum and 78.7% were optic-spinal lesions, although MS comprised 70% and NMO comprised 30% of these 78 cases. Brainstem lesion had a relative male predominancy and a young age at attack. Our findings showed that optic nerve and spinal cord lesions are the major and critical lesions in each attack of Japanese CNS demyelinating diseases. There might be distinctive Japanese pathogenic features even in Western type MS.
为了预测日本人群中多发性硬化症（MS）和视神经脊髓炎（NMO）的复发情况，我们评估了每次脱髓鞘发作的部位和年龄。我们回顾性分析了78例日本MS和NMO患者的病历。然后我们确定了49例复发缓解型患者，并对116次脱髓鞘发作进行了逐一界定。NMO的发病年龄比MS大，尽管初始症状无法预测临床表型。在这78例患者中，只有21.3%的脱髓鞘发作局限于大脑，78.7%为视神经脊髓病变，其中MS占70%，NMO占30%。脑干病变相对男性居多，发作时年龄较轻。我们的研究结果表明，视神经和脊髓病变是日本中枢神经系统脱髓鞘疾病每次发作的主要和关键病变。即使在西方型MS中，可能也存在独特的日本致病特征。
