CSF pleocytosis and expansion of spinal lesions in Japanese multiple sclerosis with special reference to the new diagnostic criteria.
New diagnostic criteria for multiple sclerosis (MS) were recently proposed from the international panel on the diagnosis of MS, and they include exclusion criteria, such as lesions extending over more than two vertebral segments on spinal MRI and CSF pleocytosis of more than 50/mm3. We reviewed the clinical features of 158 patients who satisfied the diagnostic criteria for MS except for having the above atypical paraclinical findings. All patients exhibited two or more clinical attacks and objective clinical evidence of multiple lesions without any evidence of other disorders. Thirty-three (20.9%) patients had one or both atypical paraclinical findings. Twenty-one out of the 33 patients were classified as having optico-spinal MS (OSMS), and the other 12 as non-OSMS patients with atypical large expanding or destructive cerebral, cerebellar or brainstem lesions on MRI as well as one or both atypical paraclinical findings. Based on this heterogeneity in clinical findings in MS, there is an urgent need to develop a common general concept of the "MS" syndromes, and the ethnic-related heterogeneity should be considered in the revised criteria for the diagnosis of MS.
Fukazawa
Toshiyuki
T
Hokuyukai Neurology Hospital, Niju-Yon-Ken 2-2-4-30, Nishi-ku, Sapporo 063-0802, Japan. fukazawa@my.email.ne.jp
Kikuchi
Seiji
S
Miyagishi
Ryuji
R
Miyazaki
Yusei
Y
Fukaura
Hikoaki
H
Yabe
Ichiro
I
Hamada
Takeshi
T
Tashiro
Kunio
K
Sasaki
Hidenao
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002556:Cerebrospinal Fluid Proteins / Q000378:metabolism; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007564:Japan / Q000453:epidemiology; D007964:Leukocytosis / Q000134:cerebrospinal fluid / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000150:complications / Q000473:pathology*; D012016:Reference Values; D012680:Sensitivity and Specificity; D013119:Spinal Cord Injuries / Q000209:etiology / Q000473:pathology*
D002556:Cerebrospinal Fluid Proteins