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Sclérose en plaque
1

Examens complémentaires :
L’examen

IRM

Potentiels évoqués cérébraux

Ponction lombaire
Immunoélectrophorèse

Les données
Visualisation directe des lésions
Séquence T1
Séquence T2
-injection de PC le
-Contraste normal est gr
gadolinium
inversé par rapport a T1
- LCR est noir
-LCR est blanc
- SG est plus foncée que la -SG est plus claire que la
SB
SB
- lésions sont soit :
-lésions sont plus claires
* Invisibles
que le reste de la SB
*1 peu plus foncée que SB * hyper signal
*noires ( rare )
- utilisées pour mettre en
évidence une fixation
anormale de pc  une
coloration blanche et très
intense de la lésion .
 l’utilisation de pc
permet de différencier
entre les lésions évolutives
après l’injection et les
lésions anciennes qui
restent hypo intenses
PS : Les lésions de SEP sont :
1- Multiples
2- Asymétriques
3- De limites relativement nettes
4- Formes plutôt arrondies ou ovalaires
5- Tailles de qlq mm a plusieurs cm
6- Les lésions plus irrégulières et plus étendues
sont des confluences de plaques voisines .
7- Répartissent aux régions péri ventriculaires ,
jonctions cortico-sous corticales.( SB du SNC)
- Objectivent un ralentissement de l’influx
nerveux sur les 3 voies de conduction PEV , PES ,
PEA .
- Détectent les lésions infra cliniques.
- Anomalies de LCR traduisissent la réaction
immunologique de SNC  augmentation
modérée des lymphocytes < 50 éléments / mm
- Synthèse intra thécaled’IgG de répartition
oligoclonale (un seul pic )
-

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Paraclinique de sep

  • 1. Sclérose en plaque 1 Examens complémentaires : L’examen IRM Potentiels évoqués cérébraux Ponction lombaire Immunoélectrophorèse Les données Visualisation directe des lésions Séquence T1 Séquence T2 -injection de PC le -Contraste normal est gr gadolinium inversé par rapport a T1 - LCR est noir -LCR est blanc - SG est plus foncée que la -SG est plus claire que la SB SB - lésions sont soit : -lésions sont plus claires * Invisibles que le reste de la SB *1 peu plus foncée que SB * hyper signal *noires ( rare ) - utilisées pour mettre en évidence une fixation anormale de pc  une coloration blanche et très intense de la lésion .  l’utilisation de pc permet de différencier entre les lésions évolutives après l’injection et les lésions anciennes qui restent hypo intenses PS : Les lésions de SEP sont : 1- Multiples 2- Asymétriques 3- De limites relativement nettes 4- Formes plutôt arrondies ou ovalaires 5- Tailles de qlq mm a plusieurs cm 6- Les lésions plus irrégulières et plus étendues sont des confluences de plaques voisines . 7- Répartissent aux régions péri ventriculaires , jonctions cortico-sous corticales.( SB du SNC) - Objectivent un ralentissement de l’influx nerveux sur les 3 voies de conduction PEV , PES , PEA . - Détectent les lésions infra cliniques. - Anomalies de LCR traduisissent la réaction immunologique de SNC  augmentation modérée des lymphocytes < 50 éléments / mm - Synthèse intra thécaled’IgG de répartition oligoclonale (un seul pic ) -