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[Brainstem lesion in multiple sclerosis, blink reflex, and brainstem auditory evoked potentials].

F Alonso1, A Traba, R Roldán

  • 1Sección de Neurofisiología Clínica, Hospital General Gregorio Marañón, Madrid.

Archivos De Neurobiologia
|May 1, 1992
PubMed
Summary

Blink reflex (BR) and brainstem auditory evoked potentials (BAEP) are valuable for detecting multiple sclerosis lesions, especially in the brainstem. Combining BR and BAEP tests improves diagnostic accuracy for subclinical and overt neurological damage.

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Area of Science:

  • Neuroscience
  • Clinical Neurology
  • Neurophysiology

Context:

  • Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
  • Brainstem involvement is common in MS and can lead to significant neurological deficits.
  • Assessing brainstem function is crucial for accurate MS diagnosis and management.

Purpose:

  • To evaluate the diagnostic utility of Blink Reflex (BR) and Brainstem Auditory Evoked Potentials (BAEP) in multiple sclerosis patients.
  • To compare the sensitivity of BR and BAEP in detecting brainstem lesions, both clinically apparent and subclinical.
  • To determine the correlation between specific MS symptoms and electrophysiological abnormalities.

Summary:

  • Blink reflex (BR) and brainstem auditory evoked potentials (BAEP) were recorded in 168 multiple sclerosis patients.

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  • BR demonstrated higher abnormality rates (45.75%) than BAEP (27.95%) overall.
  • Abnormality rates increased significantly in patients with brainstem symptoms (BSS+), particularly when symptoms were active (BSS+P), with BR showing 60.4% and BAEP 41.3% abnormalities.
  • BR detected subclinical lesions in 33.3% and BAEP in 16.9% of patients without prior brainstem symptoms.
  • The combination of BR and BAEP proved more effective than isolated testing.
  • Lesion localization, based on clinical signs and BR, was predominantly in the pons.
  • Facial myokymia and internuclear ophthalmoplegia were frequently associated with BR abnormalities, often localized to the pons.

    • Impact:

    • BR and BAEP are sensitive electrophysiological tools for diagnosing brainstem lesions in multiple sclerosis.
    • The combined use of BR and BAEP enhances the detection of both overt and subclinical neurological damage.
    • Findings support the use of these neurophysiological tests for improved MS patient assessment and localization of lesions within the brainstem, particularly the pons.