Glasier C M, Robbins M B, Davis P C, Ceballos E, Bates S R
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock.
AJNR Am J Neuroradiol. 1995 Jan;16(1):87-95.
To describe the clinical, neurodiagnostic, and MR findings in seven children with brain stem and spinal multiple sclerosis.
Spinal or brain stem multiple sclerosis was diagnosed in seven children between 1986 and 1992. All patients had neurologic and MR examinations as well as neurodiagnostic testing, including spinal fluid analysis and brain stem and auditory evoked potentials.
Three children had clinical findings and masslike lesions in the brain stem (two) or spinal cord (one) suggestive of neoplasm, which prompted biopsy (two) or radiation therapy (one). Five of six patients with spinal involvement had cord swelling with increased signal on T2-weighted images over at least three cord segments, and two children had essentially holocord involvement. Three children had normal cranial MR at presentation.
Multiple sclerosis involvement of the brain stem and spinal cord may be associated with extensive swelling and MR signal changes suggestive of neoplasm without typical cerebral white matter abnormalities. Serial clinical and neuroimaging examinations may be necessary to make a definitive diagnosis of multiple sclerosis in children.
描述7例脑干和脊髓多发性硬化患儿的临床、神经诊断及磁共振成像（MR）表现。
1986年至1992年间，7例儿童被诊断为脊髓或脑干多发性硬化。所有患者均接受了神经系统检查、MR检查以及神经诊断测试，包括脑脊液分析、脑干听觉诱发电位检查。
3例患儿有临床症状，脑干（2例）或脊髓（1例）有类似肿块的病变，提示肿瘤，这促使进行了活检（2例）或放射治疗（1例）。6例脊髓受累患者中有5例脊髓肿胀，在T2加权图像上至少三个脊髓节段信号增强，2例患儿基本上整个脊髓受累。3例患儿初诊时头颅MR正常。
脑干和脊髓的多发性硬化可能与广泛肿胀及MR信号改变有关，提示肿瘤，但无典型的脑白质异常。对儿童进行多发性硬化的明确诊断可能需要进行系列临床和神经影像学检查。
