Cranial MR in spinal cord MS: diagnosing patients with isolated spinal cord symptoms

MR brain scans, spinal fluid electrophoresis, and evoked responses were obtained in 10 adult patients with isolated spinal cord symptoms diagnosed as possible multiple sclerosis (MS) according to the McAlpine criteria. Typical lesions of MS were found on T2-weighted MR images in six patients. Spinal fluid abnormalities were found in four. Visual-evoked responses or brainstem auditory-evoked responses were abnormal in three. MR in conjunction with spinal fluid analysis supported the diagnosis of MS in eight of 10 patients. Evoked responses appeared less sensitive than MR in identifying subclinical lesions in this population.