[Multiple sclerosis. Clinical topodiagnosis in comparison with cerebral MRI findings]

Clinicotopographic correlations were performed in a larger group of patients with multiple sclerosis (n = 121). In the assessment of two raters working independently from one another, 73% of all clinical brainstem findings (n = 74) could be traced back to demyelination plaques in the supposed localization as visualized by MRI. The clinical topodiagnostic was especially in accordance with MRI findings concerning internuclear ophthalmoplegia (85%) and abducens palsy (79%). Cerebellar dysfunctions (n = 60) correlated with morphological findings in 87%. More than half of all patients with cerebellar and brainstem symptoms exhibited a periventricular demyelination around the 4th ventricle which was associated with the clinical topodiagnostic. Unequivocal MRI correlations could be hardly found for clinical findings of low topodiagnostical value (symptoms of the long motor and sensory pathways). The clinical status as expressed by Kurtzke's EDSS reflects the extent of cerebral demyelination as seen by MRI only in a larger patient group.