多发性硬化患者的视觉、脑干听觉诱发电位测定及其意义

目的；探讨视觉诱发电位（VEP）、脑干听觉诱发电位（BAEP）对多发性硬化（MS）的诊断意义。方法：对20例临床诊断为MS的患者进行VEP、BAEP检测，并与对照组进行比较分析。结果：MS患者VEP、BAEP的异常率分别为70％和55％。VEP、BAEP异常者中，各有72％和63％的患者，临床有相应的症状；各有28％和37％的患者临床无相应症状。结论：VEP、BAEP检测对MS的诊断有重要意义。     

多发性硬化的诱发电位检查

我们对１９９３年４月～１９９８年６月收治经临床诊断为多发性硬化（ＭＳ）的５４例患者,未经筛选进行了视诱发电位（ＶＥＰ）、脑干听觉诱发电位（ＢＡＥＰ）、体感诱发电位（ＳＥＰ）检查,其结果报告如下,旨在评价ＥＰＳ在ＭＳ诊断中的重要意义,使之更有效地应用于...     

视觉、体感及脑干听觉诱发电位对多发性硬化诊断价值的对比分析

目的：比较视觉诱发电位（VEP）、正中神经体感诱发电位（SEP）及脑干听觉诱位（BAEP）3在多发性硬化（MS）诊断中的不同价值。方法：35例MS患分别进行VEP、SEP、BAEP中的一项或多项检查，并与临床症状体征进行对照分析。结果：MS患VEP、SEP、BAEP的异常率分别为81．5％、76．2％、52％，其中有相应视神经、躯体感觉、脑干损害VEP、SEP、BAEP的异常率分别为84．6％、83．3％、69．2％，而无相应症状体征3的异常率分别为78．6％、73．3％、33．3％。结论诱发电位对MS的诊断具有重要价值。在确定MS的临床病灶和发现亚临床病灶方面VEP敏感性稍高于SEP，但明显高于BAEP。联合检测VEP、SEP、BAEP将有助于提高MS诊断的阳性率。     

多发性硬化视听体感诱发电位的对比研究

目前尚无一种特异性的检查方法用以确诊多发性硬化(MS) ,但诱发电位 (EPS)可以发现一些尚无任何临床表现的脱髓鞘病灶。我们对 1993～ 2 0 0 1- 0 4收治经临床诊断为 MS6 4例对象进行了脑干听觉诱发电位 (BAEP)、视觉诱发电位 (VEP)、体感诱发电位 (SEP)检查 ,现将结果报告如下。1　对象和方法1.1　对象　本组 6 4例符合临床确诊 42例 ,近似确诊 2 2例。男16例 ,女 48例。男女之比为 1∶ 3。发病年龄 13～ 5 6岁 ,平均 35岁。病程在 1a以内 44例 ,1～ 5 a16例 ,5 a以上 4例 ,平均病程1a2个月 ,其中病程最短 2 d,最长达 10 a。首次发…     

视觉诱发电位在多发性硬化症中的应用价值

目的：研究视觉诱发电位(vsual evoked potential，VEP)在多发性硬化症(multiple sclerosis，MS)中的临床应用价值。方法:应用棋盘格翻转方式分别对27例明确为MS患者或可疑患者(存在缓解复发特点)和27例健康成人进行VEP检测，将测量结果进行比较，与临床症状体征进行对照分析。结果:可疑诊断或明确诊断MS的患者中，有相应视神经症状者13例，异常率为85％(11／13)，无症状者14例，异常率79％(11／14)，差异有显著性意义。结论:VEP为早期诊断或发现亚临床病灶提供了病灶空间表现的依据。     

多发性硬化患者不同空间频率图形视觉诱发电位分析

目的比较多发性硬化症(MS)患者不同空间频率下的图形视觉诱发电位(P-VEP)与正常者是否有差别。方法将2011年9月-2012年4月就诊并确诊为MS患者18例(36只眼)及正常志愿者20例(40只眼)分别进行高(15′)、低(60′)空间频率下P-VEP检查,比较在2种不同空间频率下两组之间的差异。结果 MS患者P-VEP在高空间频率下P100波潜伏时为(120.50±13.04)ms,比正常者(109.21±5.38)ms延迟(P<0.05),在低空间频率下P100波潜伏时为(109.57±12.87)ms,比正常者(103.31±5.45)ms延迟(P<0.05)。MS患者在高空间频率下P100波振幅为(9.17±5.69)μV,比正常者(15.69±8.45)μV降低(P<0.05),在低空间频率下P100波振幅为(11.93±16.75)μV,与正常者振幅(13.47±9.24)μV相比差异无统计学意义(P>0.05)。将MS患者组按照矫正视力的不同分为视力≥1.0组和<1.0组,其中矫正视力≥1.0组在高空间频率下潜伏时为(113.43±8.28)ms,振幅为(12.94±5.46)μV;低空间频率下潜伏时为(111.13±11.50)ms,振幅为(11.57±5.60)μV。矫正视力<1.0组在高空间频率下潜伏时为(126.69±13.49)ms,振幅为(5.87±3.43)μV;低空间频率下潜伏时为(108.26±14.11)ms,振幅为(12.24±5.82)μV。矫正视力不同的两组在低空间频率下潜伏时和振幅之间差异无统计学意义(P>0.05)。结论与正常者相比,MS患者的P-VEP表现为潜伏时的延迟及振幅的降低,其中高空间频率下的视觉诱发电位更为敏感。在临床应用中,高空间频率下的视觉诱发电位可能能作为评价MS患者视功能的重要依据。     

儿童多发性硬化7例

多发性硬化（Ｍｕｌｔｉｐｌｅｓｃｌｅｒｏｓｉｓ，ＭＳ）是一种脱髓鞘疾病，多见于成人，１０岁以前病者少见。近年来检查手段的完善及ＭＲＩ的应用，发现儿童患者并非罕见。本院１９９４年１月～１９９７年１０月共收治７例，并进行了１～３年的随访，现报告如下。１临...     

应用新标准诊断多发性硬化

本文介绍了poser等应用临床相结合实验指标诊断多发性硬化(MS)的新标准,并对136例MS患者进行分析,与传统诊断标准(单靠临床相)比较。用新标准确诊MS组为124例,近于确诊MS组12例,用传统标准确诊MS组为87例,近于确诊MS组21例,可能MS组28例。应用新标准可提高确诊MS病例,对早期诊断MS有较大实用价值。     

亚洲型和西方型多发性硬化多形式脑诱发电位的比较

目的：探讨亚洲型和西方型多发性硬化(multiple sclerosis，MS)多形式脑诱发电位的差异。方法：对19例亚洲型和24例西方型MS患者进行了视觉诱发电位(visual evoked response，VEP)、脑干听觉诱发电位(brain-stem auditory evoked potential，BAEP)和躯体感觉诱发电位(somatosensory evoked Potential，SEP)的综合研究，并对两者的临床特点进行了比较。结果：亚洲型多发性硬化发病年龄[(35&;#177;12)岁]明显高于西方型[(27&;#177;11)岁](t=2．3378，P&;lt;0．05)。EDSS评分在亚洲型MS(5．3&;#177;2．3)也明显高于西方型(3．8&;#177;2．1)(t=2．2304，P(0．05)。亚洲型MS的VEP异常率(89％)显著高于西方型(54％)(χ^2=4．7053，P&;lt;0．05)，而BAEP异常率低(42％)显著低于西方型(71％)(χ^2=70．4663，P&;lt;0．001)。结论：亚洲型和西方型是多发性硬化的两种不同的临床亚型。     

视觉诱发电位对视神经挫伤早期诊断的应用价值

目的探讨视觉诱发电位(VEP)对外伤性视神经挫伤的早期诊断的应用价值。方法对56例经临床诊断为外伤性视神经挫伤的患者行VEP检查。结果比较视神经挫伤患者受伤眼与自身健眼的VEP结果。受伤眼VEP的P100波的振幅、潜伏期有不同程度的异常。患者视力损伤越严重,P100波的改变越明显。VEP检查能灵敏地反映视神经的损伤程度。结论 VEP能为外伤性视神经挫伤的早期临床诊断、视功能评价提供客观依据。     

Vision and Driving in Multiple Sclerosis

Schultheis MT, Manning K, Weisser V, Blasco A, Ang J, Wilkinson ME. Vision and driving in multiple sclerosis.

Objective

To examine the relationship between measures of visual dysfunction and driving performance in persons with multiple sclerosis (MS).

Design

Between-group comparison.

Setting

All data were collected in an outpatient research setting.

Participants

Persons (N=66) with MS of the relapsing remitting type (26 self-reporting visual difficulties; 40 self-reporting no visual difficulties) and 26 age- and sex-matched healthy controls.

Interventions

Not applicable.

Main Outcome Measures

Measures of vision included visual acuity, depth perception, and color perception. Driving was measured using documented accident/violation rate and self-reported driving behaviors.

Results

Quantitative analysis only revealed that MS persons with self-reported visual difficulties performed significantly worse than healthy controls on color perception (Kruskal-Wallis; χ₂²=8.89, P=.01). There were no group differences on driving behaviors, and correlational analysis revealed a lack of relationship between the selected visual (visual acuity, depth perception, color perception) and driving performance measures (documented accident/violation rate and self-limiting driving behaviors).

Conclusions

Persons with MS who self-reported difficulties with vision had acceptable visual acuity, despite demonstrating impairment in color perception. The fact that visual acuity remains the most common measure for visual fitness to drive remains problematic. There is a need to further define measures of visual dysfunction relevant to driving among this clinical population.     

多发性硬化患者中乙肝病毒感染

目的：研究多发性硬化其它神经科疾病、非神经科疾病患者血清和脑脊液中乙肝标志物的情况，并进行比较分析。方法：65例多发性硬化患者，71例其它神经科疾病患者和42例非神经科疾病患者分成3组，每例患者各取血液和脑脊液2ml，用ELISA方法测定血清和脑脊液中的HBsAg、HBsAb、HBeAg、HBeAb、HBcAb，统计各组的阳性率并进行分析。结果：血清中多发性硬化组的乙肝总感染率，HBsAb和HBeAg阳性率以及HI：bAg、HBeAg和HBcAb同时阳性的比例高于其它两组，有显著差异（P〈0．05）；脑脊液中三组各有8例，11例和4例患者有乙肝标志物阳性，不仅有乙肝抗体成分，也有抗原成分，但3组无显著差异（P〉0．05）。结论：乙肝病毒与多发性硬化是否相关尚待进一步研究。     

Elevated IL-38 Serum Levels in Newly Diagnosed Multiple Sclerosis and Systemic Sclerosis Patients

ObjectiveInterleukin (IL)-38 is a newly discovered member of the IL-1 cytokine family with a proposed anti-inflammatory profile. We studied the probable role of this cytokine in the pathogenesis of two autoimmune diseases: multiple sclerosis (MS) and systemic sclerosis (SSc).Subjects and MethodsA total of 87 MS patients and 86 SSc patients (40 new and recently untreated cases and 46 treated cases) were selected for this study. Eighty-seven and 80 age- and sex-matched healthy subjects were included as controls for MS and SSc, respectively. Clinical and paraclinical features of the patients were recorded at the time of sampling. Serum IL-38 was measured by ELISA.ResultsLevels of serum IL-38 did not significantly differ between the total MS or SSc patients compared to controls. However, levels of IL-38 were significantly higher in newly diagnosed patients of MS (206.43 ± 38.97 pg/mL, p < 0.0001) than in those previously treated (158.04 ± 39.45 pg/mL). Similarly, new/recently untreated cases of SSc patients showed increased IL-38 levels (185.19 ± 36.27 pg/mL, p = 0.001) compared to treated patients (166.82 ± 33.08 pg/mL). IL-38 levels in newly diagnosed MS patients (p = 0.007) and new/recently untreated SSc patients (p = 0.032) were significantly higher than those in healthy controls.ConclusionThe higher serum levels of IL-38 in new or recently untreated cases of MS and SSc patients than in treated patients and healthy controls suggest the possible role of this cytokine in the development of these diseases or as part of a feedback loop to attenuate the inflammatory conditions in early stages of these diseases.     

多发性硬化的临床、磁共振成像及诱发电位的综合研究

目的：研究多发性硬化患者的临床表现，起病形式，类型，分析磁共振成像和三种诱发电位的诊断价值。方法：回顾性分析51例确诊为多发性硬化患者的临床特征，头颅和脊髓磁共振成像，视觉诱发电位，脑干听觉诱发电位和体感诱发电位的结果及相互间关系。结果：本组患者以视神经脊髓炎和东方型多发性硬化为多见，头颅和脊髓磁共振成像均有病灶，视觉诱发电位的敏感性最高。结论：本组患者的临床特征符合亚洲多发性硬化的特点。磁共振成像和诱发电位相结合，能提高诊断的阳性率。     

多发性硬化的MRI诊断

目的：提高对多发性硬化（MS）MRI特征的认识。材料与方法：对22例MS患者行脑和／或脊髓MRI检查,对病变的分布、形态及病变的强化进行评价。结果：脑内病变位于测脑室周围、半卵圆中心及脑干、室旁病变其长轴多与侧脑室垂直;脊髓病变多位于预髓及上段胸髓,呈长条状。病变急性期及活动期强化,稳定期或斑痕期不强化。结论：MRI可显示MS的特征性表现,增强扫描可提高MRI对MS早期诊断的特异性,并能对MS的病理生理特点进行时间顺序学方面的观察。