Bilateral and recurrent optic neuritis in multiple sclerosis
Bilateral and recurrent optic neuritis in multiple sclerosis
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DOI：
10.1111/j.1600-0404.2010.01388.x
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发表时间：
2011-03-01
影响因子：
3.5
通讯作者：
Fagius, J.
中科院分区：
文献类型：
--
作者：
Burman, J.;Raininko, R.;Fagius, J.
目的：评估多发性硬化症(MS)患者双侧和复发性视神经炎(ON)的发生率，并将这些结果与视神经脊髓炎(NMO)和无其他疾病体征的复发性ON的流行病学资料进行比较。结果21%的患者以ON为首发症状，在MS其他症状出现前二次发作的比例为5.5%，以双侧ON为首发症状的发生率为3.8%。仅2例患者同时出现双侧On，占0.42%。结论：复发性On是MS的常见表现，无论是单侧还是双侧，由于MS是一种比NMO更常见的疾病，在评估复发On患者的工作时应予以注意。在某些情况下，即使在血清标志物NMO-IgG存在的情况下，也有必要重复MRI和腰椎穿刺术以提高诊断的准确性。
Objective -To assess the frequency of bilateral and recurrent optic neuritis (ON) in multiple sclerosis (MS) and to compare these results with epidemiological data of ON in neuromyelitis optica (NMO) and recurrent ON without other signs of disease.Methods -We identified 472 patients with diagnosis of MS from the Swedish Multiple Sclerosis Register. These patients were evaluated for the presence of ON and whether the ON was the presenting symptom of MS; unilateral or bilateral; monophasic or recurrent.Results -Twenty-one percent presented with ON as their first manifestation of MS. The proportion of patients developing a second attack of ON before demonstration of other manifestations of MS was 5.5% and the frequency of recurrent bilateral ON as the presenting symptom was 3.8%. Only two patients presented with simultaneously appearing bilateral ON corresponding to 0.42%.Conclusion -Recurrent ON, whether unilateral or bilateral, is a common presentation of MS. As MS is a much more common disease than NMO, care must be taken when evaluating the work-up of patients with recurrent ON. In some cases repeated MRI and lumbar punctures are warranted to improve diagnostic accuracy, even in the presence of the serological marker NMO-IgG.