Our own five cases of multiple sclerosis (MS) are reported and compared with the MS and neuro-Behcet (NB) cases appearing in literature.
1) Although MS tends to affect women m ore frequently than men, NB tends to affect men more frequently than women.
2) In approximately 75 percent of the MS cases, onset occurs between the third and the fourth decades, while in 85 percent of the NB cases, onset occurs during the third decade.
3) Acute or subacute onset occurs in 95% of the MS cases, but in only 57.6% of the NB cases.
4) Among the initial signs of MS, Visual disturbance, muscular weakness, and sensory disturbance are most frequent, while among those of NB, headache, motor disturbance, awl mental symptoms are most frequent.
5) The main clinical signs observed during course in MS are those of visual disturbance, and signs indicating spinal cord and brainstem involvement, while those, frequently observed in NB are motor palsy (pyramidal signs), cranial nerve signs showing brainstem damage, and various mental signs.
Painful tonic spasms, the Lhermitte rign, and internuclear ophthalmoplegia (the MLF syndrome) are frequently seen in MS but never in NB. In NB, sensory impairment is rare and occurs only temporarily during the early stage of the disease and in the exacerbated phase. As residual signs, motor disturbance is more predominant in NB than in MS.
6) Clinical course: Both disease tend towards recurrent remmission and exacerbation. The impression is that complete remission is more frequent in MS than in NB, gradual progression being more common in the latter.
7) In the NB cases, moreover, the following abnormal laboratory data are found: leucocytosis, ESR acceleration, positive CRP, increases in protein content and cell counts in the cerebrospinal fluid (CSF), and abnormal EEG patterns.
Such laboratory findings are usually obtained during the early stage or in the exacerbation phase accompanied by fever.
In MS, the laboratory data are almost normal, excluding increased gamma globulin in the CSF.
8) A lthough in our country the most common clinical MS patterns are the opticospinal and optico-brainstem types, in other countries the multiple types are most common. On the other hand, the NB patterns in our country are often of such multiple types as the cerebral-brainstem type or the cerebral-brainstem-spinal type.
As to incidence, that of MS is higher in other countries than in ours, but the reverse is true of NB; some racial or geographical causes may be involved in this difference as well as in the difference amnng the clinical pictures of both diseases.
Further studies on these two diseases, especially on theire tiology, are required.
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