医大教学模板课件

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1、多发性硬化及急性炎症性脱髓鞘多发性神经病康复康复科锁冬梅DefinitionMultiplesclerosis(MS)isachronicautoimmunediseasethatbeginsmostcommonlyinyoungadultsandischaracterizedpathologicallybymultipleareasofcentralnervoussystem(CNS)whitematterinflammation,demyelination,andglialscarring(sclerosis).Thelesionsarethereforemultiplebothin

2、spaceandtimeIncidence5~30/100,000;F:M=1.5~3.0:1Easternworld:1.4/100,000多发性硬化(multiplesclerosis,MS)是以中枢神经系统白质脱髓鞘病变为特点的自身免疫病。临床特征:病灶时间上、空间上的多发性髓鞘(myelin)是包绕神经轴突周围的一种胶质细胞膜性脂质结构中枢少突胶质细胞→MS周围Schwann细胞→GBSBasicKnowledgeNeuronMyelinandDemyelinatecreatedbygliaFattysubstanceSupport,nutrition,insulate,spee

3、dstransmissionMSplaqueisdefinedasasharplyareaofdemyelinationwithglialproliferationWhatCausesMultipleSclerosisImmunology:MSinvolvesanauto-immuneprocess—anabnormalresponsebytheimmunesystemdirectedagainstthecentralnervoussystem(CNS).MSpatient’simmunesystemcannotdifferentiatebetweenvirusproteinsandit

4、sownmyelinandthereforelaunchesanattackagainstitselfViral:itispossiblethatavirusisthetriggeringfactorinMS.Morethanadozenviruseshavebeeninvestigated,unfortunatlynooneissureWhatCausesMultipleSclerosis下一个会不会是我别杀我，是自己人杀的就是你嘻嘻GeographicincidenceofMS,1965,McAlpineClinicalfeatures------Theinitialsymptoms

5、Thesymptomsandsignsarediverseandseemtoincludeallthesymptomsthatcanresultfrominjurytoanypartoftheneuraxisfromthespinalcordtothecerebralcortex.Thechiefcharacteristicsaremultiplicityandtendencytovaryinnatureandseveritywithtime.difficultyinwalkingabnormalsensationssuchasnumbnessorafeelingof"pinsandne

6、edles"painandlossofvisionduetoopticneuritis(inflammationoftheopticnerve)Clinicalfeatures-----Othersymptomsdizzinessandvertigodysphagia(difficultyinswallowing)headachehearingproblemsspasticity(stiffness)TremoritchingnumbnesspainseizureslossofsexualityorsexualproblemsBowelandbladderincontinenceLher

7、mittesignClinicalCourses(typeofMS)------RRMS(Relapsing/RemittingMS)relapses(exacerbations):newsymptomscanappearandoldonesresurfaceorworsen.Therelapsesarefollowedbyperiodsofremission,fullyorpartiallyrecovers.Relapsesca