多发性硬化脊髓型合并周围神经病变

目的：评价多发性硬化（MS）脊髓型的临床特征，脊髓磁共振成像（MRI），神经电生理检查和腓肠神经活检的诊断价值。方法：分析14例MS脊髓型临床表现，脊髓MRI，神经电生理和腓神经活组织病理检查。结果：其临床表现为两侧肢体不对称性运动和感觉障碍的脊髓内部损害，可伴有发作性症状，有缓解和复发，脊髓MRI可以明确脱髓鞘部位，表现髓内纵行条带状或斑片状长T1长T2信号，脊髓略增粗，诱发电位有极高的敏感性，肌电图和腓肠神经病理提示周围神经脱髓鞘改变。结论：MRI、神经电生理检查及周围神经活检对MS脊髓型的早期诊断和治疗起重要作用。

MRI and Peripheral Neuropathy in Spinal Cord Multiple Sclerosis

Objective The diagnostic value of spinal cord multiple sclerosis were evaluated by the clinical manifestations, spinal cord MRI, neuroelectrophysiological examinations and sural nerve biopsies. Methods The clinical features, spinal cord MRI, the results of sura nerve biopsies and neuroelectrophysiological studies of 14 cases of spinal cord multiple sclerosis were comprehensively analyzed. Results We found asymmetric motor and sensory impairments of spinal cord in connection with the course of remissions and relapses were the distinguishing features of the disease. Paroxysmal symptoms in spinal cord multiple sclerosis were more common. MRI could define the positions of demyelinating foci. They showed intramedullary longitudinal striped or specked long T1 and long T2 signals. The spinal cord were thickened. The evoked potentials appeared with high sensitivity. Electromyogram and pathological changes of sura nerve demonstrated the existence of peripheral nerve demyelination. Conclusions MRI, neuroelectrophysiological examination and peripheral nerve biopsy play an important role for early diagnosis and treatment of spinal cord multiple sclerosis.