Multimodal evoked potentials and CSF findings in the diagnosis of multiple sclerosis

A group of 30 patients classified on clinical grounds as having definite (N = 16) or probable MS (N = 14) according to McAlpine's criteria, has been studied using multimodal recordings of evoked potentials (visual, auditory, and somatosensory) and examination of the cerebrospinal fluid (CSF) for oligoclonal bands and Link's Index. Evoked potentials examination proved extremely sensitive in discovering asymptomatic lesions of the central nervous system. CSF data, in particular the presence of oligoclonal bands, had a high sensitivity for MS. According to these electrophysiologic and immunologic results, we have reclassified our patients in conformity with the diagnostic criteria proposed by Bartel. The combination of electrophysiological and CSF data, together with common clinical criteria, led to greater diagnostic accuracy, making it possible to reclassify most patients previously considered to have probable MS as having definite MS.