Kistikintraserebral görüntüleme örneği ile başvuran multiple skleroz hastalığı

Multipl skleroz (MS) tanısında ve ayırıcı tanısında bazı olgularda çeşitli güçlükler yaşanmaktadır. Klinik belirti ve bulgular yanında, manyetik rezonans görüntüleme (MRG), beyin omurilik sıvısı (BOS) incelemesi ve uyarılmış potansiyeller tanıyı kesinleştirmek için önemlidir. Tüm bunlara rağmen bu testlerin tanısal duyarlılık ve özgüllüğü sınırlıdır. Elli yedi yaşında tavuk çiftliği işletmecisi olan erkek hasta, 35 gün önce başlayan sağ yüz yarısında uyuşma ve denge bozukluğu yakınması ile başvurdu. Sağ yüz yarısında objektif hipoestezi ve sağda Babinski bulgusu saptandı. Beyin MRG incelemesindeki; 2 cm çapında, halkasal kontrast tutulumu olan homojen lezyon öncelikle kistik bir oluşumu düşündürdü. BOS ve görsel uyarılmış potansiyel neticesinde hastanın MS olduğu anlaşıldı. Bu hastaların klinik ve nörogörüntüleme ile takibi ayırıcı tanıda değerli bilgiler sağlayabilmektedir.

There are several difficulties in diagnosing of multiple sclerosis (MS) and differential diagnosis in some cases. In addition to clinical signs and symptoms, magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis and evoked potentials are important to confirm the diagnosis. Despite all these, the diagnostic sensitivity and specificity of these tests is limited. The male patient, a poultry farmer at the age of fifty-seven, applied with complaints of numbness of right facial area and balance disorder which started 35 days ago. Objective hypoesthesia in the right half of the face and Babinski finding in the right were detected. Brain MRI study; a homogeneous lesion of 2 cm in diameter with annular contrast enhancement was thought to be primarily a cystic formation. The patient was diagnosed with MS as a result of CSF and visual evoked potential. Clinical and neuroradiologic evaluation of these patients can provide valuable information on differential diagnosis.

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