The initial diagnosis of multiple sclerosis
The initial diagnosis of multiple sclerosis
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多发性硬化症的初步诊断
DOI：
10.1002/ana.410190426
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发表时间：
1986
影响因子：
11.2
通讯作者：
G. Ellison
中科院分区：
文献类型：
--
作者：
M. Nuwer;L. Myers;G. Ellison
在过去的几个月里逐渐减少剂量(每月5毫克)。他在任何时候都没有吞咽困难的经历。亚临床肢体神经病，伴有反射障碍和蛋白细胞学分离，发生在患者首次出现复视症状的2个月内。然而，虚弱和感觉丧失的症状在接下来的4%年里没有出现。因此，虽然首次出现复视后2个月内出现的亚临床肢体神经病与多纳吉和厄尔的患者的病程一致，但在出现更明显的感觉运动症状方面的长期延迟是独一无二的。我们的患者在其他方面与多纳吉和厄尔的患者非常相似，只是到目前为止没有吞咽困难和对免疫抑制治疗的明显良好反应。在这些方面，他更接近于Gibberd的第六个病例(2)。然而，自从出现明显的肢体症状以来，我们的患者只接受了15个月的随访，我们认识到未来可能会发生这种症状。
tapering the dosage ( 5 mg each month) over the past few months. He has experienced no dysphagia at any time. Subclinical limb neuropathy with areflexia and albuminocytological dissociation occurred within 2 months of our patient's initial complaint of diplopia. Symptoms of weakness and sensory loss, however, did not occur for another 4% years. Thus, while the onset of subclinical limb neuropathy within 2 months after first experiencing diplopia is consistent with the course of Donaghy and Earl's patients, the prolonged delay in developing more overt sensorimotor symptoms is unique. Our patient is otherwise quite similar to those of Donaghy and Earl except for the absence of dysphagia and the apparently good response to immunosuppressive therapy thus far. In these respects, he more closely resembles the sixth case of Gibberd (2}. Our patient has, however, been followed for only 15 months since the onset of overt limb symptoms, and we recognize the possibility of future occurrence of such manifestations.