Clinical and oculographic examinations of saccadic eye movements in the diagnosis of multiple sclerosis.

Saccades were examined clinically and with an improved version of infrared reflection oculography in 79 patients with multiple sclerosis (31 definite, 17 probable, 31 possible cases). With regard to employing saccade recordings in the diagnosis of multiple sclerosis, suitability of saccadic parameters and examination technique for routine use was investigated. Accuracy and peak velocity of 30 degrees and 20 degrees saccades detected mild abnormalities most reliably. Latencies were not reliable enough for routine examinations. The yield of pathology with infrared reflection oculography was improved by using separate normal ranges for abduction, adduction, and interocular differences. Additional examination of vestibulo-ocular reflex suppression seemed to be a reliable supplement to saccade testing, while smooth-pursuit testing cannot be recommended for routine diagnosis. Clinical examination of saccades revealed about half of the dissociated and half of the conjugate hypermetric disorders.