多発性硬化症の臨床症状と診断

Clinical presentation and diagnosis of multiple sclerosis.

• Helen Ford

抄録

多発性硬化症（MS）の診断は、臨床的な評価と検査によって行われる。正確で信頼性の高い単一の診断検査はありません。MSは女性に多い若年成人の疾患である。視神経、脳幹、脊髄などの中枢神経系の領域に基づいて特徴的な臨床症状があります。発症時のMSの主なパターンは、少なくとも24時間持続する神経機能障害の臨床発作を伴う再発・寛解型です。鑑別診断には、他の炎症性中枢神経系疾患が含まれます。脳の磁気共鳴画像検査と腰椎穿刺が重要な検査となります。新しい診断基準が開発され、早期診断が可能となり、効果的な疾患修飾治療へのアクセスが可能となった。

The diagnosis of multiple sclerosis (MS) is through clinical assessment and supported by investigations. There is no single accurate and reliable diagnostic test. MS is a disease of young adults with a female predominance. There are characteristic clinical presentations based on the areas of the central nervous system involved, for example optic nerve, brainstem and spinal cord. The main pattern of MS at onset is relapsing-remitting with clinical attacks of neurological dysfunction lasting at least 24 hours. The differential diagnosis includes other inflammatory central nervous system disorders. Magnetic resonance imaging of the brain and lumbar puncture are the key investigations. New diagnostic criteria have been developed to allow an earlier diagnosis and thus access to effective disease modifying treatments.

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