Sanders E A, Reulen J P, Van der Velde E A, Hogenhuis L A
J Neurol Sci. 1986 Feb;72(2-3):273-85. doi: 10.1016/0022-510x(86)90015-8.
A group of 89 patients in whom multiple sclerosis (MS) has been clinically diagnosed with varying degrees of certainty, and 25 patients with optic neuritis (ON), were subjected to the following electrophysiological tests: visual evoked response (VER), auditory brainstem-evoked response (ABER), somatosensory-evoked response (SSER), blink reflex and electronystagmography (ENG). All these patients also underwent computerized tomography (CT scan) and analysis of cerebrospinal fluid (CSF). A new diagnostic procedure is proposed, combining optimum detection of definite MS with optimally economical use of the above-mentioned non-clinical tests. The results for the MS patients show that definite MS can be diagnosed much more frequently (72%) if abnormal results in the above-mentioned tests are accepted as evidence of a (subclinical) CNS lesion. Application of the clinical diagnostic criteria of McAlpine yielded "definite MS" only in 27% of our patient material. Our diagnostic criteria showed evidence for MS in 36% of the patients clinically diagnosed as having ON. The test results were inconclusive as regards the possibility of the remaining ON patients developing MS in the future.
一组89例临床上已确诊为不同程度多发性硬化（MS）的患者，以及25例视神经炎（ON）患者，接受了以下电生理检查：视觉诱发电位（VER）、听觉脑干诱发电位（ABER）、体感诱发电位（SSER）、眨眼反射和眼震电图（ENG）。所有这些患者还接受了计算机断层扫描（CT扫描）和脑脊液（CSF）分析。提出了一种新的诊断程序，将明确MS的最佳检测与上述非临床检查的最佳经济使用相结合。MS患者的结果表明，如果将上述检查中的异常结果作为（亚临床）中枢神经系统病变的证据，那么明确MS的诊断频率会更高（72%）。应用麦卡尔平的临床诊断标准，在我们的患者资料中只有27%的患者被诊断为“明确MS”。我们的诊断标准显示，在临床上被诊断为ON的患者中，36%的患者有MS的证据。关于其余ON患者未来发生MS的可能性，检查结果尚无定论。
