Swanson J W
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1989 May;64(5):577-86. doi: 10.1016/s0025-6196(12)65564-5.
The cornerstone of the diagnosis of multiple sclerosis is the neurologic history and examination. Support for the diagnosis as well as aid in the exclusion of other disorders can be obtained from other investigations. Analysis of cerebrospinal fluid can provide evidence of a central nervous system inflammatory process; evoked potential studies can provide evidence of subclinical multifocal involvement of the central nervous system. Magnetic resonance imaging can reveal dissemination of white matter lesions and help in the exclusion of other neurologic disorders. These tests have been incorporated into the modern diagnostic criteria for multiple sclerosis. The natural history of multiple sclerosis is variable; accordingly, early in the clinical course of the disorder, predicting the prognosis for a specific patient is usually difficult. Nevertheless, some features have limited predictive value.
多发性硬化症诊断的基石是神经病史和体格检查。通过其他检查可支持诊断并有助于排除其他疾病。脑脊液分析可提供中枢神经系统炎症过程的证据；诱发电位研究可提供中枢神经系统亚临床多灶性受累的证据。磁共振成像可显示白质病变的播散情况，并有助于排除其他神经系统疾病。这些检查已纳入现代多发性硬化症诊断标准。多发性硬化症的自然病程是可变的；因此，在该疾病的临床过程早期，预测特定患者的预后通常很困难。然而，一些特征具有有限的预测价值。
