多发性硬化的临床诊断

Clinical diagnosis of multiple sclerosis

多发性硬化是中枢神经系统炎性脱髓鞘疾病。目前病因未阐明,发病机制与自身免疫性反应有关。临床表现的显著特点为时间多发性(多次发作)和空间多发性(多个病变部位)。常用辅助检查手段包括头部或脊髓MRI、脑脊液免疫学、诱发电位等。最新的诊断标准为2010年McDonald标准。目前认为,多发性硬化与视神经脊髓炎在临床、病理、影像等方面不同,由于该病临床表现的多样性及缺乏特异性生物学诊断指标,其诊断仍然是临床医师面临的最大难题之一。

Multiple sclerosis （MS） is an inflammatory demyelinating disease in central nervous system. The etiology is still unknown. The pathogenesis may be related to autoimmune response. Clinical features are dissemination in time （multiple attacks） and dissemination in space （multifocal episode）. The common used examinations including brain or spinal MRI, CSF analysis and evoked potentials. The latest diagnostic criteria is McDonald criteria published in 2010. It is now accepted that neuromyelitis optica （NMO） is different from MS in clinical, pathology, imaging and so on. Due to the diversity in clinical manifestation and the lack of specific biological parameters, the diagnosis of muhiple sclerosis is still challenging.