Comi G, Canal N, Martinelli V, Medaglini S, Locatelli T, Triulzi F, Del Maschio A, Banfi G
Riv Neurol. 1987 Jan-Feb;57(1):44-7.
Till now there are no specific laboratory tests to confirm the diagnosis of Multiple Sclerosis (MS). For this reason the diagnosis of MS is based on the clinical evidence of central nervous system white matter disease with temporal and spatial dissemination of the lesions. Recent advances in neurophysiology and imaging techniques can provide more objective criteria towards more accurate and earlier diagnosis, detecting clinically unsuspected lesions. We evaluated 39 MS patients (23 definite, 7 probable, 9 possible) by Magnetic Resonance Imaging (MRI), CT scan, Evoked Potentials (EPs) testing and Cerebrospinal Fluid analysis. MRI was abnormal in 34 cases (87%) and CT scan in 14 (36%); EPs were also abnormal in 34 cases. 30 patients had both EPs and MRI alterated and 4 patients had alterated only one of the two investigations. The frequency of EPs alterations was: VEP 74%, Median SEP 44%, Tibial SEP 59% and BAEP 54%. The BAEP was more sensitive than MRI in detecting brainstem involvement. On the other hand MRI was more sensitive than SEPs in detecting somatosensory pathways involvement. The combined use of the two techniques allowed a reclassification of 10 out of 16 possible or probable MS cases.
到目前为止，尚无特异性实验室检查可确诊多发性硬化症（MS）。因此，MS的诊断基于中枢神经系统白质疾病的临床证据以及病变在时间和空间上的播散。神经生理学和成像技术的最新进展可为更准确、更早期的诊断提供更客观的标准，检测出临床上未被怀疑的病变。我们通过磁共振成像（MRI）、CT扫描、诱发电位（EPs）测试和脑脊液分析对39例MS患者（23例确诊、7例可能、9例疑似）进行了评估。34例（87%）患者的MRI异常，14例（36%）患者的CT扫描异常；34例患者的EPs也异常。30例患者的EPs和MRI均有改变，4例患者仅其中一项检查有改变。EPs改变的频率为：视觉诱发电位（VEP）74%，正中神经体感诱发电位（Median SEP）44%，胫神经体感诱发电位（Tibial SEP）59%，脑干听觉诱发电位（BAEP）54%。在检测脑干受累方面，BAEP比MRI更敏感。另一方面，在检测体感通路受累方面，MRI比SEP更敏感。两种技术联合使用使得16例可能或疑似MS病例中的10例得以重新分类。
