RESUMO
OBJECTIVE: To describe the clinical and imaging characteristics of spinal cord ring enhancement in multiple sclerosis (MS). DESIGN: Clinical case series. SETTING: Academic referral center. PATIENTS: Twenty patients with MS who had spinal cord ring enhancement were retrospectively identified from 322 cervical and thoracic spinal cord magnetic resonance imaging studies during a 3-year period. MAIN OUTCOME MEASURES: Demographics, disability, and pattern of enhancement on spinal cord and concomitant brain magnetic resonance imaging results. RESULTS: Ring enhancement was seen in 20 patients with spinal cord enhancement, most commonly in the cervical cord. Incomplete or "open" ring enhancement was the dominant pattern in 19 of the 20 patients (95%). Concurrent enhancing brain lesions were present in 14 patients, 8 of which (57%) exhibited a ring pattern of enhancement. At the time of imaging, the Expanded Disability Status Scale scores ranged from 1.0 to 7.0 (median score, 3.0). CONCLUSIONS: Ring enhancement is not an uncommon pattern for spinal cord lesions in MS, occurring with a prevalence of 6.2% (20 of 322 imaging studies). The most common pattern is incomplete ring enhancement in the cervical spinal cord. Recognition of this pattern may improve and expedite the diagnosis of MS and preclude the need for invasive diagnostic interventions.
Assuntos
Encéfalo/patologia , Esclerose Múltipla/patologia , Medula Espinal/patologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeAssuntos
Meio Ambiente , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Estações do Ano , Arizona/epidemiologia , Boston/epidemiologia , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla Recidivante-Remitente/diagnóstico , Esclerose Múltipla Recidivante-Remitente/patologia , Ohio/epidemiologia , Estudos Retrospectivos , Tempo (Meteorologia)RESUMO
The aim of this study was to determine if the interval between onset of symptoms to initial electrodiagnostic studies indicates disease progression in amyotrophic lateral sclerosis (ALS). Fifty consecutive patients referred to our neurophysiology laboratory with clinical evidence of ALS were divided into two groups by outcome scores on the ALS Functional Rating Scale (ALSFRS) using 26 as a cut-off. Our results, which showed a median of four months (range 2-24 months) duration to initial electrodiagnostics for Group I (ALSFRS scores below 26) versus 10 months (range 1-24 months) for Group II (p = 0.02), suggest this measure is a marker of disease progression in ALS.
