[Visual evoked potentials and click-evoked brainstem potentials in early diagnosis of multiple sclerosis: statistics...

95 sequential unselected patients which had been referred to our lab as certain (31), probable (32) and possible (32) MS cases were examined using checkerboard (VEP) and click-brainstem (BAEP) average potentials. In VEPs, latency of the positive wave around 100 msec, and in BAEPs, latency differences between waves III-V, I-V and latency wave V was measured. Pathology was defined as values of more than 3 SD above mean of controls. VEPs were pathological in 68%/50%/41% and BAEPs were pathological in 32%/28%/9% of the certain/probable/possible cases. Eleven of the probable cases had spinal symptomatology only; 9 of these had pathological VEPs, 4 in addition pathological BAEPs. Ten of the possible cases had spinal symptomatology only; 5 of these had pathological VEPs, 2 in additional pathological BAEPs. - Improved diagnostic certainty was reached in 11 of the 32 probable cases because of pathological VEPs (4 of these in addition had pathological BAEPs). - 10 of the 32 possible cases could be classified as probable, 8 of these because of pathological VEPs and 2 because of pathological BAEPs (the latter 2 had normal VEPs). - Monaural stimulation was not significantly more effective than binaural stimulation. In general, VEPs were clearly more useful than BAEPs in the early diagnostics of MS, and for clarification of spinal symptomatology; however in occasional cases, BAEPs might contribute to the early diagnosis.