It is a demyelinating disease of the central nervous system, commonly seen in young and middle-aged adults. The clinical features include widely disseminated lesions and neurological damage symptoms that often experience remission and relapse during the course of the disease.

bubble_chart Diagnosis

1. Medical History and Symptoms

The clinical symptoms are complex and variable, with a fluctuating course of natural remission and relapse. Infections, overexertion, trauma, and emotional stress may have some relationship with the onset of the disease. Due to the different locations of the lesions, the clinical manifestations are diverse. Common ones include:

1. Psychiatric symptoms: may manifest as euphoria, irritability, or depression.

2. Speech disorders: cerebellar lesions cause unclear pronunciation and slurred speech.

3. Cranial nerves and somatic sensation, motor, and autonomic nervous systems can all be affected, with corresponding clinical manifestations depending on the affected area.

2. Physical Examination Findings

1. Cranial nerve damage: the optic nerve is the most commonly affected, with optic nerve and optic chiasm involvement leading to retrobulbar optic neuritis. Besides the optic nerve, the oculomotor nerve, abducens nerve, and auditory nerve can also be affected, resulting in corresponding signs.

2. Sensory disorders: mostly caused by posterior spinal cord or spinothalamic tract patches. Manifestations include numbness and a band-like sensation, with transverse spinal sensory disorders appearing in the late stage [third stage].

3. Motor system dysfunction: pyramidal tract damage leads to spastic paralysis, while cerebellar or spinocerebellar tract damage results in cerebellar ataxia.

3. Auxiliary Examinations:

1. Lumbar puncture CSF examination: pressure is mostly normal, with increased protein content, mainly globulin.

2. EEG may be abnormal.

3. Visual and auditory evoked potentials may be abnormal.

4. Head CT or MRI may show patchy abnormal signals at the lesion site.

bubble_chart Treatment Measures

There is no effective treatment, and the commonly used therapies include:

1. Corticosteroids or immunosuppressants can alleviate symptoms. Methylprednisolone 1g/d intravenously, after 5-7 days switch to prednisone 30-40mg/d administered orally, gradually reducing the dose until discontinuation. Long-term treatment with azathioprine (2mg/kg/d) (average 2 years) is effective in controlling the condition.

2. Neurotrophic drugs: Citicoline (250mg intramuscularly once daily) and basic fibroblast growth factor (DFGF 1600u intramuscularly once daily) can be used as appropriate.

3. Symptomatic treatment: For painful tonic seizures, trigeminal neuralgia, and epileptic seizures, carbamazepine 0.1 three times daily can be used, and for spasms, diazepam can be administered.