儿童多发性硬化15例临床分析

CLINICAL FEATURES OF CHILDREN WITH MULTIPLE SCLEROSIS:AN ANALYSIS OF 15 CASES

目的探讨中国汉族多发性硬化(MS)病儿的临床特点。方法对2013年6月—2016年5月我院住院及门诊诊断的15例多发性硬化病儿的临床特征及治疗情况进行回顾性分析。结果本组15例病儿中,男6例,女9例;起病年龄2～12岁,平均起病年龄6岁。急性或亚急性起病;5例病儿首发症状为视力障碍、复视及视物模糊。颅脑MRI检查均异常,病灶主要分布在脑室周围、基底节、脑干和小脑区域。应用甲基强的松龙联合丙种球蛋白治疗,病儿均经过复发-缓解的过程。其中3例复发超过4次,再次用激素治疗仍然有效。结论儿童期MS以视神经炎起病多见,复发频率高,急性期激素和丙种球蛋白治疗有效。

Objective To investigate the clinical features of Chinese Han children with multiple sclerosis(MS). Methods A retrospective analysis was performed for the clinical features and treatment of 15 children who were diagnosed with MS in our hospital from June 2013 to May 2016. Results Among the 15 children with MS,there were 6 boys and 9 girls,with an average onset age of 6 years(range 2-12 years).Most children had acute or subacute onset,and 5 children had the initial symptoms of visual impairment,diplopia,and blurred vision.All children had abnormal magnetic resonance imaging findings,and the lesions were mainly distributed in the periventricular region,the basal ganglia,the brainstem,and the cerebellum.Methylprednisolone combined with gamma-globulin was used for treatment,and all children underwent relapse-remission.Of all children,3 had relapse more than 4 times and still had response to corticosteroid therapy. Conclusion Optic neuritis is the most common initial symptom of childhood MS.Childhood MS has a high frequency of recurrence,and corticosteroid and gamma-globulin are effective in the acute stage of MS.