临床孤立综合征的临床特点

Clinical features of clinically isolated syndrome

目的 探讨临床孤立综合征（CIS）的临床特点.方法 回顾性分析17例临床孤立综合征的临床资料.结果 共17例CIS患者,男5例,女12例,发病年龄10-67岁,急性起病,表现为截瘫伴尿潴留1例,肢体麻木5例,眩晕5例,面舌麻木感1例,眩晕伴面部麻木感1例,偏瘫、吞咽困难、言语不清、抽搐发作各1例.脑脊液白细胞增多4例,蛋白升高2例.MRI显示病灶位于大脑半球4例,小脑1例,脑干5例,脊髓7例,MRI显示病灶为T1WI低信号,T2WI、Flair呈高信号改变.结论 CIS是中枢神经系统首次发作的急性脱髓鞘病变,表现为运动、感觉、平衡功能受损的各种症状,以脑干和脊髓症状最常见,常规脑脊液检查改变不显著,MRI有助于确定病灶及临床诊断.CIS可能是多发性硬化的首次发作.

Objective To investigate clinical features of clinically isolated syndrome （CIS）.Method Retrospectively studied the data of 17 cases of CIS.Results 17 patients included 5 male and 12 female,the age of onset of 10-67 years-old,with acute onset.1 case had paraplegia and urine retention,5 cases of numbness of limbs,5 cases of dizziness,2 cases of dizziness and facial numbness,1 case of hemiplegia,1 case of difficult swallowing,1 case of slurred speech,1 case of seizure.Cerebrospinal fluid showed 4 cases of leukocytosis and 2 cases of elevated protein.Magnetic resonance imaging （MRI） scan demonstrated demyelimative lesions in 4 cases located in cerebral hemisphere,1 case in cerebella,5 cases in brainstem,7 cases in spinal cord.The lesions were iso-or low T1WI,high T2WI and high FLAIR abnormal intensity.Conclusions CIS refers to the first acute episode of central nervous system demyelinative disease,involving disorders of movement,sensation and balance system,most commonly presenting in brainstem and spinal cord,without significant change in regular examination of CSF.MRI is the most helpful ancillary examination in lesion localization and clinical diagnosis.CIS may he the initial episode of multiple sclerosis.