Clinic of Neurology, Clinical Centre Nis, Serbia.
Neurol India. 2010 Jul-Aug;58(4):537-41. doi: 10.4103/0028-3886.68669.
Multiple sclerosis (MS) is mostly diagnosed clinically, but the diagnosis has significantly improved through the use of brain magnetic resonance imaging (MRI), testing of cerebrospinal fluid, and multimodal evoked potentials (MEPs). Even though MRI is the superior method in diagnosing this illness, MEPs remain important because they can detect clinically silent lesions in the sensory and motor pathways of the central nervous system (CNS).
The aim of the study is to test the diagnostic sensitivity of MEPs and MRI and the ratio of their sensitivity in patients with MS.
The study subjects included 293 patients with MS with disease duration of two to six years: 249 patients with relapsing-remitting (RR) MS and 44 with primary-progressive (PP) MS. All patients were subjected to an MRI brain scan, visual evoked potentials (VEPs), median somatosensory evoked potentials (SEPs), tibial somatosensory evoked potentials (SEPs), and auditory evoked potentials (AEPs). Abnormal Findings Included : changed wave morphology, interside difference in wave amplitude, absolute and interwave latency increased by 2.5 SD as compared with the control group. The control group comprised of 35 healthy subjects. Results : In this study the most abnormal findings were tibial SEPs, median SEPs, and VEPs. Our results suggest different sensitivity of MEPs in patients suffering from different forms of MS. In RR-MS the sensitivity of tibial SEPs was statically significant (Fischer's exact probability test) as compared to other evoked potential modalities. Similarly VEPs were more sensitive as compared to AEPs. In the PP-MS, median SEPs have been found to be more sensitive than VEPs, while tibial SEPs have been found to be more sensitive than AEPs. There was no significant difference in the sensitivity of MRI and MEPs both the forms of MS.
Tibial SEPs produce the most abnormal results and the highest sensitivity in the RR-MS. We propose that this test as useful criterion for the diagnosis of MS.
多发性硬化症（MS）主要通过临床诊断，但通过脑磁共振成像（MRI）、脑脊液检查和多模态诱发电位（MEPs）的使用，诊断得到了显著改善。尽管 MRI 是诊断这种疾病的首选方法，但 MEPs 仍然很重要，因为它们可以检测中枢神经系统（CNS）感觉和运动通路中的临床无症状病变。
本研究旨在测试 MEPs 和 MRI 的诊断灵敏度以及它们在 MS 患者中的灵敏度比值。
研究对象包括 293 名病程为 2 至 6 年的 MS 患者：249 名复发缓解型（RR）MS 患者和 44 名原发性进展型（PP）MS 患者。所有患者均接受了脑部 MRI 扫描、视觉诱发电位（VEPs）、正中感觉诱发电位（SEPs）、胫后感觉诱发电位（SEPs）和听觉诱发电位（AEPs）检查。异常发现包括：波形态改变、波幅两侧差异、与对照组相比绝对和波间潜伏期增加 2.5 个标准差。对照组包括 35 名健康受试者。结果：在本研究中，最异常的发现是胫后 SEPs、正中 SEPs 和 VEPs。我们的研究结果表明，MEPs 在不同形式的 MS 患者中的灵敏度不同。在 RR-MS 中，胫后 SEPs 的灵敏度具有统计学意义（Fischer 确切概率检验），与其他诱发电位模式相比。同样，VEPs 比 AEPs 更敏感。在 PP-MS 中，与 VEPs 相比，正中 SEPs 的灵敏度更高，而与 AEPs 相比，胫后 SEPs 的灵敏度更高。两种形式的 MS 中 MRI 和 MEPs 的灵敏度均无显著差异。
胫后 SEPs 在 RR-MS 中产生最异常的结果和最高的灵敏度。我们提出该测试作为 MS 诊断的有用标准。
