The Comparison Of Two Diagnostic Criteria Of Multiple Sclerosis

Objective:Because of the great rapidly development of magnetic resonance imaging (MRI) technology,MS has recently witnessed substantial changes in the criteria used for its diagnosis.The purposes of our study is to compare the new and old classification criteria for multiple sclerosis with the collections of clinical cases .Methods:According to the retrospective analysis of the 112 MS patients who were diagnosed by Poser criteria,we studied the demography,pathogenesy,clinical manifestation,auxiliary examination(MRI,CSF,evoked potential and so on)and treatment effectiveness,and statistic methods were adopted to compare and analyze.All these cases were divided into spinal type and non-spinal type sub-groups and then we applied McDonald criteria to rediagnose and calculate the rate of definite. Results:The clinical manifestations and symptoms of these patients are various,and limb paralysis is the most common sign(67.9%).The invasion of spinal cord is predominant(70.5%).we recorded no significant differences between the spinal and non-spinal sub-group with respect to sex ratio,onset of age,couse of disease,number of attacks,cell number of cerebrospinal fluid and positive incidence of visual evoked potential(P>0.05),and between the two criteria for the diagnosis of the non-spinal type(P>0.05), while for the spinal one differs(P<0.05).Conclusion: 1)The spinal cord is the most common invasive one among the positions of the central nervous system in MS patients and it is of no help to the early diagnosis of the spinal type and no-spinal type MS with with respect to sex ratio,onset of age,couse of disease,number of attacks,cell number of cerebrospinal fluid and positive incidence of visual evoked potential.But the positive incidence of the test of the OCB of the spinal type is higher than non-spinal one. As a result, patients who have the spinal cord invasion as an initial symptom could use this test to increase the early diagnostic rate.2)The definite rate by McDonald criteria is lower than Poser criteria when we use for the diagnosis,and it is due to the strict demand of MRI.So,we should emphysis on the examination of MRI.3)The two criteria have the same value for the non-spinal one. Poser criteria eased the diagnosis standard,and can be used in the base hospital,and we should pay more attention on the test method of CSF-OCB.4) The therapeutic schedules are various and are still without a unified standard.It needs long-term studies followed up with more multi-centres and large samples to assess the different treatment protocols and prognosis of multiple sclerosis.