Comparison of magnetic resonance imaging with somatosensory testing in MS suspects

Two hundred patients suspected of having multiple sclerosis (MS), including 42 with progressive myelopathy and 11 with optic neuritis, were investigated with somatosensory evoked potentials (SEPs) and magnetic resonance imaging (MRI). Most had minimal neurological deficit, the mean Kurtzke scale being 2.65. There were 117 patients had two or more MRI lesions suggestive of MS, with a total of 527 lesions identified; 290 (55%) involved the somatosensory pathways, most commonly lying in the mid-periventricular region (thalamo-cortical radiations). There was good correlation between positive and negative MRIs and SEPs. The MRI was abnormal more frequently than the SEP, except in progressive myelopathy when both were abnormal with equal frequency. It is proposed that some cases of myelopathy in MS may be due to periventricular rather than spinal pathology. The morphology of the MRI lesion would favor conduction block not slowing of the SEP as being the prime abnormality. This appeared to be true of leg SEPs.