White matter demyelination changes what to check

Demyelinating changes in white matter are clinically determined according to the patient's clinical symptoms and age. If the patient has no obvious clinical symptoms and the imaging findings are mainly nonspecific, periodic head MRI can be performed. If the patient is elderly and shows such demyelinating changes, it is considered that most of them are caused by chronic ischemic lesions. For this kind of patients, it is suggested to perfect the screening of vascular disease-related risk factors, in addition to head MRI, head MRA (vascular MRI), neck vascular color Doppler ultrasound, blood lipid, blood glucose, blood biochemistry and other aspects of examination. Of course, for patients who show obvious clinical symptoms, or young people show typical lesions in the brain, there are many examinations for such patients, which may be multiple sclerosis or optic neuromylitis. It is necessary to perfect the relevant head MRI examination and cervical MRI examination, because patients with these diseases may involve the spinal cord. Visual evoked potential examination and blood immune-related examination should also be carried out. Lumbar puncture examination can check oligoclonal bands and IgG24-hour synthesis rate. Aquaporin 4 testing may be performed to exclude neuromyelitis-optic spectrum disease. In general, if white matter demyelination is detected, clinical examination should be performed according to the patient's clinical symptoms, age and etiology.