Nagy Helga, Rajda Cecilia, Orosz Péter, Bencsik Krisztina, Benedek Krisztina, Kéri Szabolcs, Vécsei László, Beniczky Sándor
Department of Neurology, University of Szeged, Hungary.
Ideggyogy Sz. 2013 May 30;66(5-6):191-5.
Multiple sclerosis (MS) is an autoimmune degenerating disease, where myelin degradation as well as axonal loss is present.
To asses whether recording the middle-latency components of the median nerve somatosensory evoked potentials (SEPs) increases the diagnostic sensitivity in patients with MS, and to investigate whether any of the abnormalities correlates with the severity of the clinical signs and predicts future outcome.
Twenty consecutive MS patients at early onset were included. Median and tibial nerve SEPs were recorded at the time of the referral. Extended Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) were assessed at the time of the referral and after 5-year followup.
Recording the middle-latency components increased the sensitivity of the median nerve SEPs from 50% to 75%. The overall sensitivity of the SEPs (i.e. including also tibial nerve SEPs) modestly increased (from 80% to 90%). The amplitude of the cortical N20 potential of the median nerve was inversely correlated to the clinical severity. None of the parameters could predict the future outcome.
Our results provide neurophysiological evidence for the role of axonal lesions in the clinical disability of the patients with MS.
多发性硬化症（MS）是一种自身免疫性退行性疾病，存在髓鞘降解以及轴突损失。
评估记录正中神经体感诱发电位（SEP）的中潜伏期成分是否能提高MS患者的诊断敏感性，并研究是否有任何异常与临床体征的严重程度相关以及预测未来预后。
纳入20例连续的早期发病MS患者。在转诊时记录正中神经和胫神经SEP。在转诊时和5年随访后评估扩展残疾状态量表（EDSS）和多发性硬化症严重程度评分（MSSS）。
记录中潜伏期成分使正中神经SEP的敏感性从50%提高到75%。SEP的总体敏感性（即也包括胫神经SEP）适度提高（从80%提高到90%）。正中神经皮层N20电位的波幅与临床严重程度呈负相关。没有任何参数能够预测未来预后。
我们的结果为轴突病变在MS患者临床残疾中的作用提供了神经生理学证据。
