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多发性硬化

最后审阅: 22 Oct 2024
最后更新: 24 Aug 2023

小结

定义

病史和体格检查

关键诊断因素

  • 单眼视力障碍
  • 特殊的感觉异常
完整详情

其他诊断因素

  • 女性
  • 年龄 20-40 岁
  • 足拖行或擦脚
  • 腿痉挛
  • 疲劳
  • 尿频
  • 肠道功能障碍
  • 痉挛/肌张力增高
  • 深部腱反射增强
  • 不平衡/不协调
  • 视神经盘苍白或不可校正的视力丧失
  • 对石原色盲测试板的应答有误
  • 异常眼球运动
完整详情

危险因素

  • 女性
  • MS 家族史
  • 北纬
  • 遗传因素
  • 吸烟
  • 维生素 D 缺乏
  • 自身免疫性疾病
  • EB病毒
  • 儿童和青少年超重/肥胖
完整详情

诊断性检查

首要检查

  • 大脑 MRI
  • 脊髓 MRI
  • 全血细胞计数(FBC)
  • 全套代谢检查组合
  • 促甲状腺激素
  • 维生素 B12
完整详情

需考虑的检查

  • 针对视神经脊髓炎谱系疾病(NMOSD)的抗体检测
  • 脑脊液评估
  • 诱发电位
完整详情

治疗流程

急症处理

急性复发影响功能

持续性治疗

复发缓解型 MS

继发进展型 MS

原发性进展型 MS

撰稿人

作者

Mary Alissa Willis, MD

Associate Professor and Chair

Department of Neurology

University of Mississippi Medical Center

Jackson

MS

利益声明

MAW has been compensated for Speakers' Bureau participation with Alexion, Biogen, Bristol-Myers Squibb, Genzyme, and Genentech, and advisory board participation with Alexion, Biogen, Greenwich Biosciences, Genentech, and Horizon.

鸣谢

Dr Mary Alissa Willis would like to gratefully acknowledge Dr Lael A. Stone, a previous contributor to this topic. We have since been made aware that Dr Stone is deceased.

同行评议者

Alex Rae-Grant, MD

Project Leader for Neurology

Neurological Institute

Cleveland Clinic

Cleveland

OH

利益声明

ARG declares that he has no competing interests.

Sarah A. Morrow, MD, FRCPC, MS

Associate Professor of Neurology

Department of Clinical Neurological Sciences

London Health Sciences Centre

University Hospital

Ontario

Canada

利益声明

SAM declares that she has no competing interests.

Marcelo Kremenchutzky, MD

Director

The London Multiple Sclerosis Clinic

Associate Professor

Schulich School of Medicine

University of Western Ontario

Neurologist

Clinical Neurological Sciences Department

University Hospital

London Health Sciences Centre

Ontario

Canada

利益声明

MK declares that he has no competing interests.

Abhijit Chaudhuri, DM, MD, PhD, FACP, FRCPGlasg, FRCPLond

Consultant Neurologist

Department of Neurology

Queen’s Hospital

Romford

UK

利益声明

AC declares that he has no competing interests.

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