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
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
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
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
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
治疗流程
急性复发影响功能
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 received payment for participating on the speakers' bureaus of Biogen, Genzyme, Novartis, and Genentech for speaking about multiple sclerosis. MAW also serves on the editorial board for the International Journal of MS Care.
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.
鉴别诊断
- 颈椎病引起的脊髓病变
- 纤维肌痛症
- 体位性心动过速综合征伴有或不伴有颈源性偏头痛
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