Hume A L, Waxman S G
Department of Neurology, Yale University School of Medicine, New Haven, CT 06510.
J Neurol Sci. 1988 Feb;83(2-3):191-210. doi: 10.1016/0022-510x(88)90068-8.
Pattern visual, somatosensory and brainstem auditory evoked potentials (EPs) of 14 patients with definite multiple sclerosis, 222 patients suspected of having multiple sclerosis, 26 patients with isolated optic neuritis and 40 patients with a chronic not diagnosed neurologic disorder, were compared with their clinical diagnoses on 2 1/2-year follow-up. In the MS suspects, an EP abnormality demonstrating a clinically silent lesion in any modality (65 patients) was associated with a 71% chance of clinical deterioration (48% chance of definite MS within the follow-up period). Normal EPs (121 patients) were associated with a 16% chance of deterioration (4% chance of definite MS). EPs in patients in whom the only abnormalities confirmed known lesions (36 patients) did not predict follow-up status. Visual EPs demonstrated clinically silent lesions more frequently than somatosensory and auditory EPs (22%, 12% and 5% of patients). Only one of the patients with optic neuritis and 3 of the chronic not diagnosed group had EPs demonstrating clinically silent lesions. CSF and NMR studies also correlated with follow-up in subseries of the patients.
对14例确诊为多发性硬化症的患者、222例疑似患有多发性硬化症的患者、26例孤立性视神经炎患者以及40例患有慢性未确诊神经系统疾病的患者，进行了图形视觉、躯体感觉和脑干听觉诱发电位（EP）检查，并将其与2年半随访期内的临床诊断结果进行了比较。在疑似患有多发性硬化症的患者中，EP异常显示任何一种模式下存在临床无症状性病变（65例患者），其临床病情恶化的几率为71%（随访期内确诊为多发性硬化症的几率为48%）。EP正常的患者（121例患者）病情恶化的几率为16%（确诊为多发性硬化症的几率为4%）。仅证实已知病变存在异常的患者（36例患者）的EP未能预测随访状态。视觉EP显示临床无症状性病变的频率高于躯体感觉和听觉EP（分别为患者的22%、12%和5%）。视神经炎患者中只有1例以及慢性未确诊组中有3例患者的EP显示临床无症状性病变。脑脊液和核磁共振研究也与部分患者亚组的随访结果相关。
