METHODS: This retrospective study included patients diagnosed with MS or NMOSD between July 2018 and July 2023. MS patients were clinically diagnosed using the 2017 McDonald criteria, while NMOSD patients were those who met the 2015 International Panel for NMO Diagnosis (IPND) criteria and were positive for Aquaporin-4 Antibody (AQP4-Ab).
RESULTS: The study included a total of 90 patients, with 45 diagnosed with MS and another 45 with NMOSD. Pontine trigeminal nerve lesions were observed in both MS and NMOSD, but were more prevalent in MS patients (20 % vs. 2 %, p = 0.008). Root entry zone (REZ) lesions were found in 4 of 45 MS patients, accounting for 9 % (95 % CI: 3 %-17 %), and were absent in the NMOSD group; however, there was no significant difference between the two groups (p = 0.12). Of the MS patients with pontine trigeminal nerve lesions, 6 out of 9 (63 %; 95 % CI, 36 %-98 %) exhibited bilateral lesions, which was significantly more prevalent compared to the NMOSD group (13 % vs. 0 %, p = 0.03).
CONCLUSIONS: The presence of pontine trigeminal nerve lesions, particularly when bilateral, are significantly more prevalent in MS patients than in those with NMOSD, suggesting their utility as a distinctive marker and potential diagnostic indicator specifically for MS.
方法:这项回顾性研究包括2018年7月至2023年7月诊断为MS或NMOSD的患者。MS患者使用2017年麦当劳标准进行临床诊断,而NMOSD患者是符合2015年国际NMO诊断小组(IPND)标准且水通道蛋白-4抗体(AQP4-Ab)阳性的患者.
结果:该研究共包括90名患者,45例诊断为MS,另外45例诊断为NMOSD。在MS和NMOSD中均观察到桥三叉神经病变,但在MS患者中更为普遍(20%vs.2%,p=0.008)。在45例MS患者中有4例发现了根进入区(REZ)病变,占9%(95%CI:3%-17%),并且在NMOSD组中缺席;然而,两组间差异无统计学意义(p=0.12)。在患有桥脑三叉神经病变的MS患者中,9人中有6人(63%;95%CI,36%-98%)表现为双侧病变,与NMOSD组相比,明显更普遍(13%vs.0%,p=0.03)。
结论:桥脑三叉神经病变的存在,特别是当双边时,MS患者比NMOSD患者明显更普遍,表明它们作为一种独特的标记和潜在的诊断指标,特别适用于MS。