以帕金森症状为首发表现的多发性硬化

Multiple sclerosis with a primary manifestation of Parkinsonism

目的探讨以帕金森症状为首发表现的多发性硬化（MS）患者的临床特点及可能的发病机制。方法回顾性分析作者医院住院的3例以帕金森症状为主要表现的MS患者的临床与影像学特点以及治疗效果。结果3例患者均以帕金森症状为主要临床表现，均有复发缓解病史，头部MRI检查提示为MS。给予糖皮质激素冲击治疗后症状均较治疗前明显缓解。结论MS患者病灶并非只累及白质，也有可能累及锥体外系的黑质纹状体系统等其他神经系统区域。

Objective To explore the clinical characteristics and the possible pathogenesis of presenting parkinsonism as a primary manifestation in multiple sclerosis （MS） patients. Methods A retrospective analysis in 3 cases of MS presenting with parkinsonism was adopted. Their clinical manifestations, imaging features and therapeutic efficacy were evaluated. Results All three patients experienced relapsing remitting course and had a good response to steroids. Also, cranial magnetic resonance imaging （MRI） showed many demyelinating lesions evaluated as MS attacks. Conclusions These cases demonstrated that MS may be also affect the other systems such as the nigrostriatal system, not only in the white matter.