Usefulness of different stimuli in visual evoked potentials

The goal of this study was to determine the relative usefulness of the flash (FL), pattern reversal (PR) of 56', and PR of 28' in 62 patients (pts) with either MS (34) or non-MS (28) compared with normals (19). An abnormal visual evoked potential was found in 58%, 69%, and 81% of the eyes tested in possible, probable, and definite MS and in 88% of the non-MS group. The 28' PR produced the most abnormal responses, the greatest number with either greater than 3 standard deviations (SD) from the mean or greater than 2 SD in both MS and non-MS groups. The FL was second best at producing the most abnormal responses, but more often produced the only abnormality (29), compared with 28' PR (11). The 56' PR produced the only abnormality in none of the MS pts and in only one of the non-MS pts. In all categories (most abnormal, greater than 3 SD, greater than 2 SD, the only abnormality of greater than 3 SD or greater than 2 SD, and other peaks abnormal), the 28' PR was usually by far the best stimulus for definite (and probable) MS, but equally as effective was the FL in the possible MS pts Our data suggest the usefulness of 28' and not 56' PR, but the FL is especially useful in pts with possible MS.