视神经炎的临床及诊断

目的了解视神经炎的临床特征。方法分析视神经炎患者病史、头颅磁共振、腰穿等资料。结果①急性及慢性期视神经炎患者脑脊液炎性脱髓鞘改变各为4例/6例及27例/54例,磁共振显示脑白质异常信号占27%;②26例脑脊液及血液病毒系列检查阴性;③视神经炎易与多种病因的视神经疾病混淆;④急性期(半月内)视神经炎对大剂量类固醇激素短程冲击疗法显效快。结论视神经炎发病可能与炎性脱髓鞘有关,与病毒感染尚无明确关联,临床应与多种病因鉴别。

Clinical characteristics in patients with optic neuritis

Objective To explored the clinical features of optic neuritis in neurology.Methods The information of medical history,cranial MRI,lumber puncture and et al in patients with optic neuritis were discussed.Results 1.The changes of cerebrospinal fluid in both acute and chronic stages were of inflammatory demyelination,accounting for four patients out of six patients and twenty-seven out of fifty-four respectively.Cranial MRI showed abnormal changes in brain white matter accounting for twenty-seven percent.2.The virus serials were not turned up with PCR test in twenty-six patients.3.The manifestations of optic neuritis were often as alike as that of various diseases.4.The patients in two weeks were well responded to high dose steroid.Conclusions The neurological changes in patients with optic neuritis were suggestive of demyelinating disease.And differential diagnosis was indispensable.