Pediatrik Multipl Skleroz Tanı Kriterleri
Özet
Pediatrik multiple skleroz (MS), teşhisi zor olan kronik inflamatuar nörolojik bir hastalıktır. İlk demiyelinizan olayla başvuran bir çocuğun daha sonra MS hastalığı ile uyumlu gidişat geliştirip geliştirmeyeceğini belirlemek zordur. Başvuru semptomları ne kadar atipikse ve çocuk ne kadar küçükse, MS tanısı koymadan önce ayırıcı tanısını oldukça iyi yapmak gerekmektedir. Pediatrik MS tanısı için merkezi sinir sistemindeki (MSS) inflamatuar hastalık aktivitesinin zaman ve mekan içinde yayılmış olması gerekmektedir. Mekânsal yayılım; MS ile karakteristik olan bir veya daha fazla T2 hiperintens lezyonun, MSS’nin dört alanından (periventriküler, kortikal veya jukstakortikal, infratentoryal beyin bölgeleri, omurilik) ikisinde veya daha fazlasında bulunmasıyla gösterilebilir. Zamansal yayılım ise herhangi bir zamanda gadolinyum tutan ve tutmayan lezyonların eşzamanlı varlığıyla veya takip MRG’sinde, başlangıç taramasına kıyasla yeni bir T2 hiperintens ya da gadolinyum tutan lezyonun varlığıyla gösterilebilir.
Pediatric multiple sclerosis (MS) is a chronic inflammatory neurological disorder that is difficult to diagnose. It is difficult to determine whether a child presenting with a first demyelinating event will subsequently develop a course consistent with MS. The more atypical the presenting symptoms and the younger the child, the better the differential diagnosis should be made before making a diagnosis of MS. For the diagnosis of pediatric MS, inflammatory disease activity in the central nervous system (CNS) should be spread over time and space. Spatial spread can be demonstrated by the presence of one or more T2 hyperintense lesions characteristic of MS in two or more of four areas of the CNS (periventricular, cortical or juxtacortical, infratentorial brain regions, spinal cord). Time spread may be indicated by the simultaneous presence of gadolinium-enhancing and non-gadolinium-enhancing lesions at any time, or by the presence of a new T2 hyperintense or gadolinium-enhancing lesion on a follow-up MRI compared to the initial scan.
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