急性多发性硬化症的临床病理分析

AStudyonacutemultiplesclerosis

为探讨急性多发性硬化症的临床病理特点及其诊断和鉴别诊断要点，对１０例急性多发性硬化症（ＡＭＳ）尸体解剖病例作了临床病理分析。该病是多发性硬化症中一种少见的致死性类型。患者突出的临床特点为精神异常、瘫痪和大小便失禁。脱髓鞘病变表现为影斑、白质内空泡状病变及软化灶三种形式。其病变可单独存在也可互相移行。确诊本病主要根据上述病理组织学改变。还对ＡＭＳ和急性播散性脑脊髓炎的鉴别要点进行了讨论。

Withthepurposeofinvestigatingtheclinicopathologicalchangesandthecriterionfordiferentialdiagnosis,tencasesofAcutemultiplesclerosis(AMS)wereanalysed.Thedatasuggestedthatitsclinicalcoursewasanacuteneurologiceventcharacterizedbypsychicsyndrome,paralysisandincontinenceofbowelmovementandurination.Pathologicaly,thedemyeli-nationlesionconsistedofthreepatterns,i.e.:vascularorspongylesions,shadowplaquesandlique-factionornecrosis.Oneoftheaboveformscouldexistindividualyorcoexistwiththeothers.Theaccuratediagnosiswasmadeonlyafterautopsy.CriterionforthediferentialdiagnosisbetweenAMSandADEMwerediscussed.