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Visual pattern evoked responses and blink reflexes in assessment of MS diagnosis. A clinical study of 135 multiple
Abstract:
VEPs were measured after pattern reversal in 135 MS patients and 30 control subjects. Neurological findings were documented in a standard manner. An extensive ophthalmological examination of all subjects was part of the study. The latency of P2 was abnormally delayed in 82% of the "definite", in 60% of the "probable" and in 65% of the "possible" MS groups respectively. The VEP was more often delayed in relation to ophthalmological disturbances. Changes in the MS classification had to be made in more than 10% of the patients, due to delay of VEP latency. These were patients with a "spinal" form of MS, which is known to create diagnostic problems. Optically and electrically evoked blink reflexes were recorded in 107 MS patients. All patients with mesencephalic lesions had delayed responses of the optically evoked reflex. 74% of the patients with caudal brainstem lesions had delayed latencies of the components of the electrically evoked blink reflex. The blink reflex was delayed in 18 additional patients without brainstem signs. The possibility of delineating clinically silent brainstem lesions by investigating blink reflexes is discussed.
Insights
Visual evoked potentials (VEPs) and blink reflexes effectively identify neurological impairments in multiple sclerosis (MS) patients. These electrophysiological tests aid in diagnosing MS, even in cases with subtle or clinically silent brainstem lesions.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Multiple Sclerosis (MS) diagnosis relies on clinical and imaging findings.
- Electrophysiological tests like VEPs and blink reflexes offer objective measures of neural pathway function.
- Subtle or clinically silent lesions, particularly in the brainstem, can pose diagnostic challenges.
Purpose of the Study:
- To evaluate the utility of Visual Evoked Potentials (VEPs) and blink reflexes in diagnosing and characterizing Multiple Sclerosis (MS).
- To assess the correlation between VEP abnormalities, ophthalmological findings, and MS classification.
- To explore the potential of blink reflexes in detecting clinically silent brainstem lesions in MS patients.
Main Methods:
- Pattern reversal Visual Evoked Potentials (VEPs) were recorded in 135 MS patients and 30 controls.
- Optically and electrically evoked blink reflexes were measured in 107 MS patients.
- Neurological and ophthalmological examinations were conducted for all participants.
Main Results:
- Abnormal P2 latency delays were observed in 82% of definite, 60% of probable, and 65% of possible MS groups.
- VEP delays were more frequent in patients with ophthalmological disturbances.
- Over 10% of MS classifications were revised due to VEP latency delays, particularly in spinal MS forms.
- Delayed optically evoked reflexes were noted in all MS patients with mesencephalic lesions.
- 74% of MS patients with caudal brainstem lesions showed delayed electrically evoked blink reflexes.
- 18 additional MS patients without apparent brainstem signs had delayed blink reflexes.
Conclusions:
- VEPs are valuable for diagnosing MS and can necessitate classification changes, especially in spinal forms.
- Blink reflex abnormalities correlate with brainstem lesions, suggesting their utility in detecting subclinical pathology.
- Electrophysiological assessments, including VEPs and blink reflexes, are crucial for comprehensive MS evaluation and diagnosis.