Clinical Comparative Study Of Multiple Sclerosis And Neuromyelitis Optica

Background and Objective: multiple sclerosis (MS) and neuromyelitisoptica(NMO) are common demyelinating disease of the central nervoussystem(CNS), both of which can affects the optic nerve and spinal cord in the earlystage, causing clinical manifestations have many similarties. But there are significantdifferences between their early treatment and prognosis. In this paper, we conducteda clinical comparative analysis to these disease from the general, aspects onset form,the first clinical manifestations, imaging features, laboratory examination andtreatment effects, summarized the clinical features, thereby enhancingcomprehensive understanding of the diseases and providing assistance for earlydiagnosis and treatment.Methods: We summarized52cases of MS and34cases of NMO in theChian-Japan Union Hospital of Jilin University from October2010toDecember2014.From the clinical features of the two diseases,we conducted aretrospectively analysis. Using SPSS17.0package processing data, P <0.05wasstatistically significant.Results:1.The comparison of general, men and women constitute about MS is1:1.89and NMO is1:10.33; the average age of onset of MS is32.33±10.39years,NMO is36.03±6.83years.The highest prevalence about MS is20to39years(67.3%) and NMO is30to49years (76.47%). NMO patients with age ofonset are later than that of MS about4.7years (P=0.03) and have more female patients(P=0.006). MS onset is more common in young people, and NMO is morecommon in middle-aged (P=0.014).2.Incidence comparison, MS and NMO with acute or subacute onset, but MSwith subacute (46.2%) onset is more common.NMO with acute onset (34.9%)(p=0.038) is more common.3.Comparison of the first clinical symptoms,The rate ofvision disorder(P=0.001), sphincter disorders(P=0.008), swallowing and drinking ordysarthria barrier (P=0.023) of NMO is significantly higher than MS. Limbweakness in MS with monoplegia are higher than NMO ((P=0.029), while theincidence of paraplegia in NMO are higher than MS (P=0.033); The rate of beltedsense (P=0.009) and deep sensory disturbances (P=0.008) of NMO are higher thanMS，in the patients who with sensory impairment; NMO patients with visualimpairment in both eyes are morecommon than MS, and the visually impaired in the relatively more severe thanMS.4. Comparison of imaging features, MS patients had brain MRI lesions wassignificantly higher than the rate of NMO(P <0.001). MS lesions in the headinvolving the lateral ventricle (71.1%), semi-oval center (53.3%) are more common,the long axis of lesions is usually perpendicular to the lateral ventricles. While NMOlesions located in the head near the cerebral cortex (46.2%), lateral side (38.5%),brainstem (30.8%) are more common, Abnormal signal is atypical subcortical oradjacent to the ventricles showed a patchy, cerebellum no lesions. MRI of the spinalcord in contrast, Cervical(MS vs NMO,43.75%vs45.45%), thoracic(MS vs NMO,28.13%vs33.33%) spinal cord in patients with MS and NMO is the mostcommon site of involvement of spinal cord. The presence of spinal cord lesions inNMO patients with longitudinally extensive spinal cord lesions(LESCLs) >3segments) ratio was significantly higher than that of MS (P <0.01).5.Laboratory comparison, MS patients with abnormal cerebrospinal IgG indexincreased rate (P=0.015), oligoclonal bands positive rate (P=0.002) wassignificantly higher than NMO, while serum NMO-IgG-positive rate (P <0.01),serological own associated antibody positive rate (P=0.015)and elevated CSFprotein concentration abnormal rate (P=0.03) of NMO was significantly higher thanMS.6.NMO acute phase and after treatment EDSS scores were significantly higherthan MS.In acute phase, MS patients with hormone therapy effective rate (82.8%)was significantly higher than that of NMO (56.6%), P=0.027.Conclusion: MS and NMO are two different independent disease, althoughthere are similarities between the two, but in the form of onset, clinical features,imaging characteristics and laboratory tests have significant differences. In clinicalwork, we should improve the level of early differential diagnosis of MS and NMO.