Yıl: 2004 Cilt: 11 Sayı: 1 Sayfa Aralığı: 35 - 39 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Atypical demyelinating disorders suggesting multiple sclerosis

Öz:
Amaç : Klinik tablo, MRG bulguları, elektrofizyolojik çalışmalar ve beyin biyopsisi daha önce tariflenen demiyelinizan hastalıkları düşündürmeyen iki hastayı sunduk. Materyal ve Metod : İlk hastamız optic nörit tablosunu takibeden 3.5 aylık süreç sonunda bilinç kaybı ve koma tabloları sonrası kaybedildi. Sol hemipleji nedeniyle gelen diğer hastanın MRG'sinde çok sayıda çevresi kontrast tutan nodüler lezyon gözlenmiş, steroid ve azotioprin tedavisi ile rahatlamıştı. Tartışma : MS şüphesi ile değerlendirilen hastalarda klinik tanı gayret gerektirmektedir. Daha önceki bilgilere bağlı önseziler halen en önemli bölümü oluşturmaktadır. Tanı klinik seyir, nöroradyolojik bulgular ve beyin biyopsisi ile konur. Sonuç : MS şüphesi ile değerlendirilen hastalarla karşılaşıldığında nörologlar tarafından değişik basamakların takibini önermekteyiz.
Anahtar Kelime: Multipl skleroz Tanı teknik ve işlemleri Demiyelinizan hastalıklar

Konular: Genel ve Dahili Tıp

Multipl sklerozu düşündüren atipik demiyelinizan hastalıklar

Öz:
Objective : We present two patients with clinical course, MRI findings, electrophysiologic studies, and brain biopsy not suggestive of any previously described demyelinating disorder. Materials and Method : One with history of optic neuritis became comatose in a steady pattern within 3.5 months and died. The other who developped left hemiplegia showed multiple ring-enhanced nodular lesions in MRI and good response to steroid and azothioprine. Discussion : The assesment of the patient suspected of having MS remains a clinical challenge in which sound judgement is of paramount importance. The diagnosis was established by the clinical course, the neuroradiological findings, and the result of brain biopsy. Conclusion : We suggest that several steps should be followed by a neurologist when first confronted by a patient suspected of having Multiple Sclerosis.
Anahtar Kelime: Demyelinating Diseases Multiple Sclerosis Diagnostic Techniques and Procedures

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Olgu Sunumu Erişim Türü: Erişime Açık
  • 1. Paty OW. Mc Farlin DE. Mc Donald WI : Magnetic Resonance Imaging and laboratory aids in the diagnosis of multiple sclerosis. Ann Neurol 1991 ;13 : 227-31. 2. Fieschi C, Gasperini C, Ristori C, et al : Patients with clinically definite multiple sclerosis, white matter abnormalities on MRI, and normal CSF if not multiple sclerosis, what is it ? JNeurol-Neurosurg-Psychiatry 1995; 58: 255-6. 3. Matthews B. Differential diagnosis of multiple sclerosis and related disorders. In A Compston, G Ebers, H Lassmann, et al (eds). Mc Alpine’s multiple sclerosis. 3rd ed. London: Churchill Livingstone, 1998:223-250. 4. Horten B, Price RW, Jiminez D: Multifocal Leukoencephalitis temporally remote from herpes zoster. Ann Neurol 1981 ; 9: 251. 5. Gronseth GS, Ashman EJ. Practice parameter : the usefullness of evoked potensials in identifying clinically silent lesions in patients with suspected multiple sclerosis. Neurology 2000; 54:1720-5. 6. Frederikson JL, Petrera J, Larsson HB; Serial MRI, VEP, SEP in acute optic neuritis. Acta-Neurol-Scand 1996; 93: 246-51. 7. Adams R, Victor M, Rapper A: MS and allied demyelinative diseases. Principles of Neurology. New York, Mc Graw-Hili companies, p 910, 1997. 8. Poser CM, Paty DW, Scheingber LC, et al. New diagnostic criteria for multiple sclerosis. Ann Neurol 1983 ; 13 : 227-31. 9. Fieschi C, Gasperini C, Ristori C, et al: Diagnostic problems in clinically definit multiple sclerosis patients with normal CSF and multiple MRI abnormalities. Eur J Neurol 1994; 1:127-33. 10. Pirtulla T, Nurmikko T: CSF oligocland bands. Mel and the diagnosis of multiple sclerosis. Acta-Neurol 1995 ; 82 : 468-71. 11. Dalton CM, Brex PA, Miszkiel KA, et al. Spinal cord MRI in clinically isolated optic neuritis.J Neurol Neurosurg Psychiatry. 2003 ;74:1577-80. 12. Gean-Marton AD, Vozina LG, Marton KI, et al : Abnormal corpus callosum. A sensitive and specific indicator of multiple sclerosis. Radiology 1991 ; 180:215-22. 13. Allen I: Pathology of multiple sclerosis. In Matthews WB (ed). Mc Alpine’s Multiple Sclerosis.2nd ed. Edinburgh: Churchill Livingstone, p 341-78 , 1991. 14. Arnold DL, De Stefano N, Collins DL et al: Imaging of axonal damage in multiple sclerosis.Neurol 1994;44:340. 15. Koopmans RA, Li DKB, Grochowski E, et al: Benign versus chronic progressive multiple sclerosis: 1. MRI features. Ann Neurol 1989 ; 25: 74-81. 16. Rivera E, Badilla L, Eurolo J et al : Balo concentric sclerosis. Rev Med Chil, 1997; 125 : 927-30. 17. Sekijima Y, Tokuda T, Hashimoto T et aI . Serial MRI study of a patient with Balo’s concentric sclerosis treated with immunoadsorption plasmapheresis. Mult Scler 1997; 2 : 291-4. 18. Bolay H, Karabudak R, Tacal T et al: Balo’s concentric sclerosis. J Neuroimaging 1996;6: 98-103. 19. Kim MO, Lee SA, Choi CC, et al: BaIo’s concentric sclerosis a clinical case study of brain MRI, biopsy, and proton MRS findings. J-Neurol-Neurosurg-Psychiatry 1997 ;62 : 655-8. 20. Longo M, Maiorana A, Meduri M, et al : Acute multiple sclerosis simulating a cerebral tumor: A case report. Rays ( Milano) 1987; 12 : 45-8. 21. Taveras MJ : Classification of demyelinating disease. In: General pathological conditions. Neuroradiology, 3rd edi. William&Wilkins Company, USA, Chp 4, p 147, 1996. 22. Brück W, Schmied M, Suchanck C, et al : Oligodentrocytes in the early course of multiple sclerosis. Ann Neurol 1994; 35: 65-73. 23. Rudick R. Mechanisms of disability progression in primary progressive multiple sclerosis : are they different from secondary progressive multiple sclerosis ? Multiple Sclerosis 2003 ; 9 :210-2. 24. Losseff NA, Wang L, Lai HM, et al: Progressive cerebral atrophy in multiple sclerosis. A serial MRI study. Brain 1996; 119:2009-19. 25. Chang A, Tourtellotte WW, Rudick R, Trapp BD.Premyelinating Oligodendrocytes in chronic lesions of ultiple clerosis.N Engl J Med. 2002 ; 346:165-73. 26. Mc Donald WI, Miller DH, Barnes D : The pathological evolution of multiple sclerosis. Neuropathol AppI Neurobiol 1992; 18(4): 31 9-34. 27. Simon JH, Thompson AJ.Is multiple sclerosis still a clinical diagnosis? Neurology. 2003;61:596-7. 28. Murakami Y, Matsuishi T, Kato H ,et al: Balo’s concentric sclerosis in a 4-year-old Japanese infant. Brain-Dev 1998 ; 20 : 250-2. 29. Garbem J, Spence AM, Alvord EC, et aI : BaIo’s concentric demyelination diagnosed premortem.Neurology 1986; 36:1610-14.
APA KOCER A, Gozke E, ÖRE Ö, US Ö (2004). Atypical demyelinating disorders suggesting multiple sclerosis. , 35 - 39.
Chicago KOCER Abdulkadir,Gozke Eren,ÖRE Özgül,US Önder Atypical demyelinating disorders suggesting multiple sclerosis. (2004): 35 - 39.
MLA KOCER Abdulkadir,Gozke Eren,ÖRE Özgül,US Önder Atypical demyelinating disorders suggesting multiple sclerosis. , 2004, ss.35 - 39.
AMA KOCER A,Gozke E,ÖRE Ö,US Ö Atypical demyelinating disorders suggesting multiple sclerosis. . 2004; 35 - 39.
Vancouver KOCER A,Gozke E,ÖRE Ö,US Ö Atypical demyelinating disorders suggesting multiple sclerosis. . 2004; 35 - 39.
IEEE KOCER A,Gozke E,ÖRE Ö,US Ö "Atypical demyelinating disorders suggesting multiple sclerosis." , ss.35 - 39, 2004.
ISNAD KOCER, Abdulkadir vd. "Atypical demyelinating disorders suggesting multiple sclerosis". (2004), 35-39.
APA KOCER A, Gozke E, ÖRE Ö, US Ö (2004). Atypical demyelinating disorders suggesting multiple sclerosis. İnönü Üniversitesi Tıp Fakültesi Dergisi, 11(1), 35 - 39.
Chicago KOCER Abdulkadir,Gozke Eren,ÖRE Özgül,US Önder Atypical demyelinating disorders suggesting multiple sclerosis. İnönü Üniversitesi Tıp Fakültesi Dergisi 11, no.1 (2004): 35 - 39.
MLA KOCER Abdulkadir,Gozke Eren,ÖRE Özgül,US Önder Atypical demyelinating disorders suggesting multiple sclerosis. İnönü Üniversitesi Tıp Fakültesi Dergisi, vol.11, no.1, 2004, ss.35 - 39.
AMA KOCER A,Gozke E,ÖRE Ö,US Ö Atypical demyelinating disorders suggesting multiple sclerosis. İnönü Üniversitesi Tıp Fakültesi Dergisi. 2004; 11(1): 35 - 39.
Vancouver KOCER A,Gozke E,ÖRE Ö,US Ö Atypical demyelinating disorders suggesting multiple sclerosis. İnönü Üniversitesi Tıp Fakültesi Dergisi. 2004; 11(1): 35 - 39.
IEEE KOCER A,Gozke E,ÖRE Ö,US Ö "Atypical demyelinating disorders suggesting multiple sclerosis." İnönü Üniversitesi Tıp Fakültesi Dergisi, 11, ss.35 - 39, 2004.
ISNAD KOCER, Abdulkadir vd. "Atypical demyelinating disorders suggesting multiple sclerosis". İnönü Üniversitesi Tıp Fakültesi Dergisi 11/1 (2004), 35-39.