ÖZET

Amaç:

Multipl skleroz (MS), prognozu öngörülemeyen otoimmün nörodejeneratif bir hastalıktır. MS lezyonları, elektrofizyolojik çalışmaların uyarılmış potansiyellerini (UP) etkileyebilir. Bu çalışmada elektrofizyolojik parametreleri kullanarak MS hastalarının prognozunu öngörmeyi amaçladık.

Gereç ve Yöntem:

İki yıl boyunca, vizüel UP (VUP) ve somatosensoryal UP (SUP) tetkikleri yapılmış olan MS hastaları çalışmaya dahil edildi. Hastaların demografik özellikleri, MS tipi, atak sayıları, muayene esnasındaki genişletilmiş engellilik durum skalaları (EDSS), elektrofizyolojik UP, kan testleri, ilk beyin omurilik sıvısı (BOS) ve manyetik rezonans görüntüleme (MRG) bulguları değerlendirildi.

Bulgular:

Toplam iki yüz elli dokuz MS hastası değerlendirildi. Her iki elektrofizyolojik inceleme için de, tespit edilen patolojik sonuçlar ile hastaların EDSS skorları arasında istatistiksel olarak anlamlı bir ilişki vardı (p<0,001). MS ataklarının sayısı, sadece SEP patolojileri ile ilişkili bulundu (p=0,045). BOS IgG indeksinin VEP üzerinde anlamlı bir etkisi yokken (p=0,065), posterior tibial SEP üzerinde istatistiksel olarak anlamlı bir etkisi vardı. IgG indeksi yüksek olan MS hastalarında, posterior tibial SEP incelemeleri istatistiksel olarak anlamlı derecede iki yanlı patolojikti (p=0,039). Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu tanı kriterlerini karşılayan MS hastalarında hem VEP hem de tibial SEP incelemelerinde istatistiksel olarak anlamlı olan iki taraflı bozukluk vardı (sırasıyla p=0,003 ve 0,000). Başlangıçta elektrofizyolojik incelemelerde patolojisi olan hastaların güncel MRG’lerinde spinal ve infratentoryalde istatistiksel olarak anlamlı derecede daha sık demiyelinizan lezyonlar vardı.

Sonuç:

UP MS hastalarında klinik progresyonu öngörebilir. MS hastalığında nörofizyolojik anormallikler prognostik faktör olarak kullanılabilir.

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Elektrofizyolojik Çalışmalar Multipl Skleroz Prognozunu Öngörebilir mi?

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References