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Clinico-electrophysiological correlates in patients with relapsing-remitting multiple sclerosis
M G Manova1, I I Kostadinova, N T Chalakova-Atanasova
1Department of Neurology, Higher Medical Institute, 15A Vassil Aprilov St., 4000 Plovdiv, Bulgaria.
Introduction:
The degree of neurological deficit was evaluated in patients with multiple sclerosis (MS) relapse by the Expanded Disability Status Scale (EDSS), transcranial magnetic stimulation (TMS) and visual evoked potentials (VEPs). Clinical and electrophysiological changes before and after treatment were compared in an attempt to find significant associations between the indicators of disease activity.
Material And Methods:
In all the patients (n = 35, mean age 32.05 +/- 2.67 years) EDSS rating was assessed prior to and 2 months after the beginning of treatment with methylprednisolone (MP)--13 patients, and with MP in combination with cyclophosphamide (CPH)--22 patients. Transcranial magnetic stimulation with measuring central latency time (CLT) was performed in 20 patients (mean age 30.85 +/- 8.01 years) before and at the end of the 2nd month after treatment with MP independently (9 patients) and MP combined with CPH (11 patients). In another 15 patients with a mean age of 33.67 +/- 7.45 years VEPs are examined (P100 latency) before and on the 2nd month after treatment with MP (4 patients) and MP combined with CPH (11 patients).
Results:
CLT (P < 0.001) and P100 (P < 0.001) were significantly shortened after treatment in comparison with the baseline values. A significant correlation (P < 0.05) between CLT and the pyramid subscale was found.
Conclusion:
The results suggests that CTL and P100 reflect the effect of treatment on the intensity of the pathological process, the CLT correlating with the severity of the pyramid deficit according to EDSS rating in the course of the treatment.