Miller D H, Ormerod I E, Rudge P, Kendall B E, Moseley I F, McDonald W I
Multiple Sclerosis Nuclear Magnetic Resonance Research Group, Institute of Neurology, London, England.
Ann Neurol. 1989 Nov;26(5):635-9. doi: 10.1002/ana.410260508.
A combined clinical and magnetic resonance imaging follow-up study was undertaken to determine the risk of early progression to multiple sclerosis in patients who present with clinically isolated lesions of the brainstem or spinal cord. Progression to multiple sclerosis was seen in 13 patients (57%) who had a brainstem syndrome and in 14 patients (42%) who had a spinal cord syndrome after mean intervals of 15 and 16 months, respectively. The risk of progression was increased by the presence of oligoclonal bands in the cerebrospinal fluid of patients with either syndrome and by the presence of disseminated brain lesions, as detected by magnetic resonance imaging, in those with a spinal cord syndrome. Follow-up revealed evidence of multiphasic disease in 24 (69%) of 35 patients who had disseminated lesions on magnetic resonance imaging scans at presentation, suggesting that multiple sclerosis is the usual cause of such lesions.
开展了一项临床与磁共振成像联合随访研究，以确定出现脑干或脊髓临床孤立性病灶的患者早期进展为多发性硬化症的风险。出现脑干综合征的13例患者（57%）进展为多发性硬化症，出现脊髓综合征的14例患者（42%）进展为多发性硬化症，平均间隔时间分别为15个月和16个月。两种综合征患者的脑脊液中存在寡克隆带，以及脊髓综合征患者磁共振成像检测到的脑内散在病灶，均增加了疾病进展的风险。随访发现，35例初次磁共振成像扫描有散在病灶的患者中有24例（69%）出现多相性疾病的证据，提示多发性硬化症是此类病灶的常见病因。
