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[Diagnostic criteria of multiple sclerosis: electrophysiological criteria]
C Fischer1, N André-Obadia, F Mauguière
1Service de Neurologie Fonctionnelle et Epileptologie, Hôpital Neurologique, BP Lyon Montchat, 69394 Lyon-France. Catherine.Fischer@univ-lyon1.fr
Abstract:
We have made a review on the use of evoked potentials in multiple sclerosis (MS) for the past 30 years, in the diagnosis of MS, to disclose subclinical lesions or to assess atypical symptoms. Yet the role of evoked potentials in evaluation of multiple sclerosis has been changed since MRI is now widely and easily used for the diagnosis of MS. Evoked potentials are useful when symptoms are atypical without any objective impairment and when symptoms have already recovered at the time of clinical examination. Visual evoked potentials and somatosensory evoked potentials are widely used thanks to their diagnostic value and their ability to disclose spatial dissemination of multiple sclerosis. Evoked potentials have to be recorded in validated technical conditions such as to ensure reliability of data and have to be interpreted in reference to a population of healthy people recorded in the same conditions and in the same age range as MS patients.
Insights
Evoked potentials aid in diagnosing multiple sclerosis (MS) by revealing subclinical lesions and atypical symptoms, especially when MRI is inconclusive or symptoms have resolved. Visual and somatosensory evoked potentials are key tools for assessing MS progression and spatial dissemination.
Area of Science:
- Neuroscience
- Clinical Neurology
Context:
- Review of evoked potentials (EPs) in multiple sclerosis (MS) over 30 years.
- Evolving role of EPs with the advent of Magnetic Resonance Imaging (MRI) for MS diagnosis.
- EPs remain valuable for atypical MS presentations and resolving symptoms.
Purpose:
- To review the historical and current applications of evoked potentials in multiple sclerosis diagnosis and assessment.
- To highlight the diagnostic utility of visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs) in MS.
- To emphasize the importance of standardized recording and interpretation of EPs for reliable data.
Summary:
- Evoked potentials have been instrumental in diagnosing MS, detecting subclinical lesions, and evaluating atypical symptoms for three decades.
- While MRI is now standard, EPs retain importance for cases with subtle or resolved neurological deficits.
- VEPs and SEPs are crucial for demonstrating the spatial spread of MS lesions, aiding diagnosis and management.
Impact:
- Provides a comprehensive overview of evoked potentials' contribution to multiple sclerosis understanding.
- Clarifies the complementary role of EPs alongside advanced imaging techniques like MRI.
- Underscores the necessity of rigorous methodology for accurate electrophysiological assessment in MS.