| Abstract | Multipla skleroza je kronična, upalna, autoimuna, bolest središnjeg živčanog sustava, tijekom koje dolazi do progresivne demijelinizacije bijele tvari mozga i kralježnične moždine. Uobičajni simptomi su vidne i okulomotorne smetnje, parestezije, slabost, spasticitet i urinarna disfunkcija. Ovisno o kliničkom obliku bolesti, nakon različito dugog razdoblja, periodi pogoršanja i poboljšanja postupno dovode do invaliditeta. Danas se dijagnoza multiple skleroze bazira na anamnezi, kliničkom statusu, analizi EMP, MR I CSL, no niti jedan test nije patognomoničan. Mnoge bolesti uzrokuju slične simptome kao MS i tako otežavaju konačnu dijagnozu. U diferencijalnu dijagnozu multiple skleroze tako spadaju tumorski procesi, vaskularne ( AV malformacije, vaskulitisi), infektivne (HTLV 1 i 2, HIV, sifilis, borelioza), traumatske (hernije diska), autoimune (ADEM, NMO, RA, APS, SLE, Sjögrenova i Behçetova bolest, sarkoidoza), psihijatrijske (konverzivni poremećaj), metaboličke (manjak vitamina B12, centralna pontina mijelinoliza) te druge bolesti. Iako je diferencijalna dijagnoza multiple skleroze široka, kvalitetno uzeta anamneza, klinički pregled, paraklinički kriteriji te kontinuirano praćenje pacijenta mogu je znatno suziti i tako omogućiti pravilno liječenje pacijenta. |
| Abstract (english) | Multiple sclerosis is a chronic, inflammatory, autoimmune disease of central nervous system, in the course of which there is a progressive demyelinization of white matter of the brain and of the spinal cord. Most common symptoms are visual and oculomotory disturbances, paresthesias, weakness, spasticity and urinary dysfunction. Depending on the clinical type of disease, after a varying amount of time periods of worsening and getting better gradually lead to disability. Today, the diagnosis of multiple sclerosis is based on anamnesis, clinical status, analyses of EMP, MRI and CSL, however neither of those tests are patognomonical. Many diseases cause similar symptoms to those of MS and thus make the final diagnosis difficult. Therefore, in the differential diagnosis of MS there are tumors, vascular diseases (AV malformations, vasculitis), infectious diseases (HTLV 1 and 2, HIV, syphilis, boreliosis), traumas (discus hernia), autoimmune diseases (ADEM, NMO, RA, APS, SLE, Sjogren's and Behçet's, sarcoidosis, psychiatric illnesses (conversive disorder), metabolic diseases (B12 deficiency, central pontine myelinolysis) and various other diseases. Although the differential diagnosis of multiple sclerosis is broad, a proper anamnesis and clinical exam, paraclinical criteria and continuous assessment of the patient can narrow it down significantly and make the correct treatment of the patient possible. |
