[Additional examinations for ascertaining the diagnosis of multiple sclerosis]

The relevance of additional findings was examined in 50 patients in whom multiple sclerosis had been diagnosed. Magnetic resonance (MR) technique revealed morphological changes in 49 patients (688 foci), whereas CT scan visualised foci with modified enhancement in 35 patients only (133 foci) (70%). Oligoclonal antibodies were found in the CSF of 96% of the patients as pointers towards the inflammatory immunological process. Enhanced daily IgG production was seen in 57-70% of the patients, whereas in 52% stimulated lymphocytes were identified in the CSF. Total protein content and cell count in the CSF differed in only 22 and 26%, respectively. Functional deterioration of the myelin sheath resulted in 72% of MS patients in an increased latency of visually evoked potentials. Hence, oligoclonal antibodies in the CSF and multiple foci revealed by MR are the most reliable additional findings in MS and should be considered as essential aids to confirm the diagnosis. A modified schema is suggested in which CT is replaced by MR and the proof of oligoclonal antibodies is given a higher ranking. Pathological changes in evoked potentials are relevant only if clinical symptoms are absent. Sensitivity disturbances and manifestations of brain stem disorders are somewhat less significant.