Naslov
Differential diagnosis of central nervous system demyelination

Autori
Kiđemet-Piskač, Spomenka, Brinar, Vesna ; Titlić, Marina ; Gašparić, Irena ; Djaković, VIšnja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Neurologia Croatica / - , 2001, 108-109

Skup
3rd Croatian congress on neurology

Mjesto i datum
Rijeka, Hrvatska, 10.10.2001. - 13.10.2001

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
differential ; diagnosis ; central nervous system ; demyelination

Sažetak
The introduction of magnetic resonance imaging (MRI) has made a huge contribution to the identification and localization of various demyelinating lesions in the central nervous system (CNS), especially in multiple sclerosis (MS). The form and distribution of demyelinating lesions on MRI are different and offten highly suggestive of the diagnosis, but they are not pathognomonic for various demyelinating disease. We analyzed 170 patients, 114 (67%) women and 56 (33%) men with MRI signs of demyelinating disease of CNS. CDMS was diagnosed in 119 (70%), and acute disseminated encephalomyelitis in 19 (11%) patients. A majority of these patients showed a monophasic course of disease with a tendency to resolution. Myalgic encephalomyelitis was diagnosed in two (1%) patients, while biopsy verified sarcoidosis with massive brain lobe demyelination was found in one (0.5%) patient. According to the clinical signs and MRI findings, vascular disease was diagnosed in 17 (10%) patients. In two (1%) patients, small areas of abnormalities seen in subcortical white matter with corresponding laboratory and clinical findingsresembled vasculitis (lupus erythmatosus). In 15 (8.8%) patients, extensive confluent changes in the cerebral ahite matter were oberved.Although these changes are often associated with dementia, it was found in only six patients. In 10 (5.9%) patients, focal demyelination with various clinical signs was recorded. In three women, the lesions were located in the pons with clinical symptoms of trigeminal neuralgia in one and hemifacial in two of them. In the next four years, they developed no other signs of MS. In another seven patients, focal demyelinations were found in the spinal cord. In threee of them, the highly suspicious signs of primary progressive MS deeloped. We conclude that demyelinating changes in the cerebral or spinal white matter, seen on MRI, may frequently be indistinguishable from those seen inmultiple sclerosis. To make an accurate diagnosis, it is very important to compare such MRI findings with clinical signs and laboratory findings.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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