Kofler B
Wien Med Wochenschr. 1985 Jan 31;135(1-2):35-8.
A central topic of recent research on multiple sclerosis (MS) concerns the development of sensitive neurophysiological techniques with the ability to detect lesions at the earliest possible stage. Specifically, the recording of evoked potentials has during the past decade demonstrated its diagnostic value by disclosing clinically silent lesions especially of the optic nerve and brainstem region. The visual evoked potential (VEP) was registered in 177 patients with definite, probable and possible MS (McAlpine). Abnormal latencies were obtained in 86/46/34% of these three patient groups, respectively. 44% of all MS-patients without clinical or anamnestic evidence of optic nerve dysfunction showed delayed VEPs. The brainstem auditory evoked potential (BAEP) enables topodiagnostic statements to be made regarding brainstem lesion site. This is very valuable, since the brainstem region is especially prone to demyelination, which clinically as well as morphologically often evades detection. 74/60/48% of our definite, probable and possible MS-patients had pathological BAEPs. 50% of asymptomatic patients had an abnormal BAEP-result. Computer tomography yielded brainstem pathology in only 10% of all MS-patients.
近年来多发性硬化症(MS)研究的一个核心主题是开发能够在尽可能早的阶段检测病变的敏感神经生理学技术。具体而言,在过去十年中,诱发电位记录通过揭示特别是视神经和脑干区域的临床无症状病变,证明了其诊断价值。对177例确诊、可能和疑似MS(麦克阿尔平标准)患者进行了视觉诱发电位(VEP)检测。在这三组患者中,VEP潜伏期异常的比例分别为86%/46%/34%。在所有无视神经功能障碍临床或既往史证据的MS患者中,44%的患者VEP潜伏期延长。脑干听觉诱发电位(BAEP)能够对脑干病变部位进行定位诊断。这非常有价值,因为脑干区域特别容易发生脱髓鞘,在临床和形态学上常常难以检测到。在我们确诊、可能和疑似MS的患者中,BAEP异常的比例分别为74%/60%/48%。50%的无症状患者BAEP结果异常。计算机断层扫描显示,所有MS患者中只有10%存在脑干病变。