Brain-stem auditory evoked potentials in multiple sclerosis: the relation to VEP, SEP and CSF immunoglobulins

Area of Science:

• Neuroscience
• Neurology
• Clinical Neurophysiology

Background:

• Multiple Sclerosis (MS) diagnosis relies on detecting demyelination in the central nervous system.
• Evoked Potentials (EP) and cerebrospinal fluid (CSF) analysis are key diagnostic tools.
• The diagnostic utility of specific EP tests, including brain-stem auditory evoked potentials (BAEP), requires ongoing evaluation.

Purpose of the Study:

• To retrospectively analyze the diagnostic value of BAEP, pattern reversal visual evoked potentials (VEP), somatosensory evoked potentials (SEP), and CSF immunoglobulins (CSF-IG) in 100 MS patients.
• To assess the contribution of BAEP to the EP test battery, particularly in conjunction with other diagnostic markers.
• To evaluate the impact of incorporating a 'dispersion ratio' into BAEP criteria for enhanced sensitivity.

Main Methods:

• Retrospective analysis of 100 patients diagnosed with multiple sclerosis.
• Investigated brain-stem auditory evoked potentials (BAEP), visual evoked potentials (VEP), somatosensory evoked potentials (SEP), and cerebrospinal fluid immunoglobulins (CSF-IG).
• Compared EP abnormalities with CSF-IG results and evaluated BAEP sensitivity with and without a 'dispersion ratio' criterion.

Main Results:

• BAEP abnormalities were found in 42% of patients with normal VEP and SEP, and 38% with normal CSF-IG.
• The likelihood of at least one abnormal EP was lower in patients with normal CSF-IG compared to those with abnormal CSF.
• Utilizing a 'dispersion ratio' for BAEP criteria significantly increased test sensitivity compared to conventional methods.

Conclusions:

• Brain-stem auditory evoked potentials (BAEP) provide significant diagnostic information in multiple sclerosis, even when other evoked potentials are normal.
• BAEP should remain an integral part of the evoked potential test battery for suspected MS cases.
• The inclusion of a 'dispersion ratio' enhances the sensitivity of BAEP in detecting neurological abnormalities in MS.