Analysis Of Clinical Manifestation In Multiple Sclerosis

Multiple sclerosis (MS) is the most common primary demyelinating disease of central nervous system (CNS). It belongs to a kind of autoimmune disease. It's clinical feature is multiple in focus of infection and time. With the exception of 10%~20% of the total who are progressive aggravation, the majority of the rest all manifest with relapsing-remitting course. The most common affecting focus are the white matter surrounding the ventricle, optic nerve, conduct tract of spinal cord, brain stem and cerebellum etc. It's early diagnosis is a tough problem. To deepen the recognition to MS and reduce misdiagnosis and missed diagnosis, we summarize the features of multiple sclerosis in China as follows. The source of the 103 cases comes from patients whose final diagnosis is MS in Chinese-Japan Union Hospital of Jilin University from January 1994 to December 2004 using clinical statistical method. There are 32 males and 71 females in the ratio of 1:2.219. The minimum onset is 8 years old and the maximum is 60. Among the total, there is one patient less than 10 years old. 89.32% of them are between 10-50 years of age. 10 cases are greater than 50 years of age. The mean onset of the total is 34.4, with the peak onset between 30-40 years of age. In our group, there are 90 cases with relapsing-remitting MS, 2 cases with secondary progressive and 11 cases with primary progressive MS. The longest course is 15 years, while the shortest is 2 days ,on the average of 28.3 months. The morbidity frequency is between 1-23. The mean is 3. Acute or subacute onset is 86.4%. Chronic onset (To reach the peak pathogenetic condition after one month) is 14 cases (13.6%). 21.35% onset for the first time or relapse in certain motivation. Catching cold (8 cases), exertion (4 cases), fever (3 cases), the inoculation of rabies vaccine(2 cases). Besides cold, tooth extraction, after parturition, tonsillitis also can provoke onset and relapse. Catching cold is the most common motivation, which hints that MS is related to viral infection. Extremity weakness(59cases,57.3%), sensory disturbance (34cases,33.0%) and visual disorders (25cases,24.3%) are the commonest initial symptoms in order. Moreover, it is characterized by diversity and complexity,Such as sphincter disorder, headache, vomiting, diplopia, cervicodynia, the decrease of hearing, facial palsy and so on. In addition Lhermitte sign, clumsy of reaction, ataxia, vertigo, algospasm, aphasia, aching pain all over the body, lumbodorsal pain quaque one case. Symptoms of nervous system: Extremity weakness (89.3%), sensory disturbance (66.0%), sphincter disorder (48.5%)and visual disorders (39.9%) are the commonest symptoms by turns. Signs of nervous system: Impairment of optic nerves is the most frequent sign in the impairment of cranial nerves. Both eyes are affected simultaneously or one eye is affected firstly. Abnormalities of the motor system are common in MS, as manifested by weakness (79, 76.7%), pathologic reflex (upper limb 16 cases, lower limb 77 cases), abnormality of deep, superficial reflex and muscular tension (74), among which, 47 cases are paraplegia, 18 cases are tetraplegia, 16 cases are hemiplegia, 8 cases are monoplegia and 3 cases are triplegia. Sensory signs are seen frequently inpatients with MS. There are 75 patients to show up sensory disturbance, including superficial sensation deficiency (69,67.0%). There are 6 cases manifesting with Lhermitte sign, which accord with the report of Asia. It is possible that spinal cord is more involved in Asian. Others: ataxia is 15 cases (14.6%), sphincter dysfunction is 48 cases, nystagmus is 19 cases (18.4%), the majority are horizontal nystagmus (15 cases). Special symptoms and signs: Seizure symptoms are often seen in the period of relapse and paracmasis in MS, which is rarely as initial symptom. It's characterized by attacking frequently, transient and stereotypy again and again in a short time. Sometimes it can relieve by itself, but it maybe necessary to apply carbamazepine or the same kind drugs. There are 5 cases (4.9%) manifesting with seizure symptoms, including algospasm (2 cases) and epilepsy (3 cases). Impairments of peripheral nervous system can also occur in MS, including ending sensory disturbance (5 cases) and peripheral sensory disturbance (4 cases). Electromyogram examination finds 14 cases to have impairment of peripheral nervous system in 20 cases,confirming the existence of impairment of peripheral nervous system in MS. The mechanism maybe that CNS has the same antigen as PNS. Clinical location: spinal cord (68.9%), optic nerve (43.7%),cerebrum (33.0%), brain stem (24.3%), cerebellum (7.8%), acoustic nerve (2.9%), Devic syndrome (9, 8.7%). On the whole, in our subjects ages of onset are yong in patients with MS. The minimum onset is 8 years old and the maximum is 60. 89.32% of the patients are between 10-50 years of age, with the peak onset between 30-40...