老年人多发性硬化的临床特点

发布时间：2018-04-24 05:06

本文选题：多发性硬化 + 脱髓鞘疾病　；参考：《山东医药》2016年43期

【摘要】：目的探讨老年人多发性硬化(MS)的临床特点。方法患有MS的老年患者25例,对其病因、临床表现、辅助检查结果、治疗及预后结果等作回顾性分析。结果 25例患者中,男12例、女13例,年龄60~75岁。既往曾患干燥综合征2例、类风湿关节炎1例。发病前有诱因者4例,亚急性起病21例,复发缓解型22例。神经系统症状为肢体无力14例、感觉障碍10例、大小便障碍8例、视力障碍8例、智能障碍7例。25例行血清抗水通道蛋白抗体-4检查均阴性。MRI检查示大脑半球病变22例、脑干病变9例、颈髓病变7例、胸髓病变5例。23例诱发电位异常。急性期均予以糖皮质激素治疗,临床痊愈4例、好转16例。结论老年人MS以亚急性起病为主,多为复发缓解型;老年人MS常见症状是肢体无力、感觉障碍、视力障碍、二便障碍;脑脊液、MRI、神经电生理检查有助于本病的诊断;糖皮质激素在老年人MS治疗中发挥一定作用。
[Abstract]:Objective to investigate the clinical features of multiple sclerosis (MS) in the elderly. Methods 25 elderly patients with MS were retrospectively analyzed for their etiology, clinical manifestations, auxiliary examination results, treatment and prognosis. Results among the 25 patients, 12 were male and 13 female, aged 60 ~ 75 years. There were 2 cases of Sjogren's syndrome and 1 case of rheumatoid arthritis. There were 4 cases with inducement before onset, 21 cases with subacute onset and 22 cases with relapse and remission. There were 14 cases of limb weakness, 10 cases of sensory disturbance, 8 cases of defecation and urination, 8 cases of visual impairment, 7 cases of intellectual disorder and 25 cases of mental retardation. All of them were negative in serum anti-aquaporin antibody -4. MRI examination showed cerebral hemispheric lesion in 22 cases. Brainstem lesions 9 cases, cervical spinal cord lesions 7 cases, thoracic myelopathy 5 cases. 23 cases abnormal evoked potentials. All of them were treated with glucocorticoid in acute stage, 4 cases were cured and 16 cases improved. Conclusion the main symptoms of MS in the elderly are subacute onset, most of which are relapse and remission, the common symptoms of MS in the elderly are limb weakness, sensory disturbance, visual impairment and defecation disorder, MRI and electrophysiological examination of cerebrospinal fluid are helpful for the diagnosis of this disease. Glucocorticoids play a role in the treatment of elderly MS.
【作者单位】：赣南医学院第一附属医院;
【分类号】：R744.51

【相似文献】