[Comparison of the Aulhorn flicker test with visual evoked potentials in the diagnosis of optic neuritis]

The Aulhorn flicker test and visual evoked cortical potentials (VEP) are of great value for the diagnosis of optic neuritis (ON). In the present study, the two methods were compared for the first time within the same group of patients. The study comprised 405 eyes (175 suffering from active or subsided ON). The results were evaluated with a double-blind procedure. With the flicker test, the subjective brightness of flickering light is determined as a function of the flicker frequency. This test gives pathological results only in active ON and normalizes when the active phase is over. The test can discriminate between active and subsided ON as well as between the recurrent and chronic courses of the disease. Differentiation is not possible with the VEP, since the VEP latencies are prolonged even after the end of the active period of the disease. The sensitivity of the flicker test was 84.4%. The sensitivity of the VEP was 72.7% for our group of patients suffering from ON if the criterion of increased latency was used alone. In the diagnosis of multiple sclerosis (MS), the proportion of correctly identified pathological VEP results is increased because of the detection of demyelination of the optic nerve that causes no clinical symptoms. The specificity of the flicker test was 97.8% and that of the VEP 86.5%. If both methods were combined, the sensitivity was 98.4% and specificity 99.6%. The two methods obviously have different characteristics and seem to rely upon different demyelination effects. Each method has its advantages and disadvantages as well as optimal indications.(ABSTRACT TRUNCATED AT 250 WORDS)