Zabad Rana K, Stewart Renee, Healey Kathleen M
Department of Neurological Sciences, University of Nebraska Medical Center College of Medicine, Omaha, NE 68198-8440, USA.
University of Nebraska Medical Center College of Nursing, Omaha, NE 68198-5330, USA.
Brain Sci. 2017 Oct 24;7(10):138. doi: 10.3390/brainsci7100138.
During recent decades, the autoimmune disease neuromyelitis optica spectrum disorder (NMOSD), once broadly classified under the umbrella of multiple sclerosis (MS), has been extended to include autoimmune inflammatory conditions of the central nervous system (CNS), which are now diagnosable with serum serological tests. These antibody-mediated inflammatory diseases of the CNS share a clinical presentation to MS. A number of practical learning points emerge in this review, which is geared toward the pattern recognition of optic neuritis, transverse myelitis, brainstem/cerebellar and hemispheric tumefactive demyelinating lesion (TDL)-associated MS, aquaporin-4-antibody and myelin oligodendrocyte glycoprotein (MOG)-antibody NMOSD, overlap syndrome, and some yet-to-be-defined/classified demyelinating disease, all unspecifically labeled under . The goal of this review is to increase clinicians' awareness of the clinical nuances of the autoimmune conditions for MS and NMSOD, and to highlight highly suggestive patterns of clinical, paraclinical or imaging presentations in order to improve differentiation. With overlay in clinical manifestations between MS and NMOSD, magnetic resonance imaging (MRI) of the brain, orbits and spinal cord, serology, and most importantly, high index of suspicion based on pattern recognition, will help lead to the final diagnosis.
在最近几十年里，自身免疫性疾病视神经脊髓炎谱系障碍（NMOSD），曾一度被广泛归类于多发性硬化症（MS）范畴，如今已扩展至包括中枢神经系统（CNS）的自身免疫性炎症性疾病，这些疾病现在可通过血清学检测进行诊断。这些由抗体介导的中枢神经系统炎症性疾病与MS有着相似的临床表现。本综述中出现了一些实用的学习要点，其针对视神经炎、横贯性脊髓炎、脑干/小脑及半球肿胀性脱髓鞘病变（TDL）相关的MS、水通道蛋白4抗体和髓鞘少突胶质细胞糖蛋白（MOG）抗体NMOSD、重叠综合征以及一些尚未明确/分类的脱髓鞘疾病的模式识别，所有这些在 下均未进行特异性标注。本综述的目的是提高临床医生对MS和NMSOD自身免疫性疾病临床细微差别的认识，并突出临床、副临床或影像学表现中极具提示性的模式，以改善鉴别诊断。鉴于MS和NMOSD临床表现存在重叠，脑部、眼眶和脊髓的磁共振成像（MRI）、血清学检查，以及最重要的基于模式识别的高度怀疑指数，将有助于做出最终诊断。
