Huang Wen-Juan, Chen Wei-Wei, Zhang Xia
Department of Neurology, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.
Exp Ther Med. 2017 Jun;13(6):3163-3166. doi: 10.3892/etm.2017.4410. Epub 2017 Apr 28.
Multiple sclerosis (MS) is a complex neurodegenerative disease affecting the central nervous system (CNS). The onset of MS has been typically observed in individuals aged from 20 to 40-years, with the female to male ratio of 1:2. MS appears as abrupt onset of focal sensory disturbances that is accompanied by unilateral painless damage of vision, double vision, limb weakness, unsteadiness of gait, and bowel or bladder symptoms. Whereas the exact etiology of the disease is unknown, observational research has suggested genetic and environment influences through an underlined pathophysiology widely believed to be autoimmune in nature. Indeed, plaque of demyelination inside of the CNS with relative conservation of axons remains the clinical symptoms of MS. However, considerable advances in understanding the pathology have contributed to an early diagnosis, particularly the exact neuroanatomical setting of plaques. Accordingly, magnetic resonance imaging has been considered as the primarily adjunctive modality for the constant detection of abnormal white matter. In addition, the analysis of cerebrospinal fluid contents has also been of interest for the diagnosis to discriminate other affections such infection or vasculitis. These resulted in a broad variety of therapies that considerably control the activity and change the course and prognosis of the disease. In the present review, we evaluate the current state of knowledge on MS with emphasis on the pathology itself, the diagnosis and common therapeutical approaches accurately used.
多发性硬化症(MS)是一种影响中枢神经系统(CNS)的复杂神经退行性疾病。MS的发病通常出现在20至40岁的人群中,女性与男性的比例为1:2。MS表现为局灶性感觉障碍的突然发作,伴有单侧无痛性视力损害、复视、肢体无力、步态不稳以及肠道或膀胱症状。尽管该疾病的确切病因尚不清楚,但观察性研究表明,通过一种普遍认为本质上是自身免疫性的潜在病理生理学,遗传和环境因素会产生影响。事实上,中枢神经系统内脱髓鞘斑块伴轴突相对保留仍是MS的临床症状。然而,在理解病理学方面取得的重大进展有助于早期诊断,尤其是斑块的确切神经解剖位置。因此,磁共振成像被认为是持续检测异常白质的主要辅助手段。此外,脑脊液成分分析对于鉴别感染或血管炎等其他疾病的诊断也很有意义。这些进展带来了各种各样的疗法,能够显著控制疾病的活动并改变其病程和预后。在本综述中,我们评估了关于MS的当前知识状态,重点关注病理学本身、诊断以及准确使用的常见治疗方法。