Did Evoked Potential Studies Lose Their Significance in the Diagnosis of Multiple Sclerosis?
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 10, Issue 2
Abstract
Objective: Since magnetic resonance imaging (MRI) became central in the diagnosis and follow-up of Multiple Sclerosis (MS), evoked potentials (EP) studies appear to have lost their value, despite their ability to indicate the real-time status of the physiological system, and the nature of the lesion. In this study, we investigated the diagnostic utility of EPs and their correlation with MRI findings in our patients who were evaluated for suspected MS. Materials and Methods: In this study, the medical records at first admission of 100 patients who were evaluated for suspected MS were analyzed retrospectively. The correlations of EPs with clinical and MRI findings were analyzed. Results: The VEP test was more sensitive than orbital MRI in detecting optic nerve involvement. tSEP agreed with 81% of the MRI findings and mSEP with 55%. On the other hand, in patients with normal spinal MRI, mSEP and tSEP indicated functional impairment in 44% and 67% of the cases, respectively. Although MRI seems to be more useful in detecting brainstem abnormalities, only the BAEP study revealed subclinical involvement in 12% of the patients. Again, VEP indicated subclinical involvement in 18% and mSEP in 29% of the cases. Discussion: Evoked potential studies are still valuable in revealing abnormalities that cannot be detected by conventional MRI techniques. It is an indisputable fact that EP is more sensitive than MRI in detecting optic nerve lesions. In particular, EPs are especially useful for diagnosis and follow-up when MRI cannot be performed or takes too much time. Introduction Since magnetic resonance imaging (MRI) became central in the diagnosis and follow-up of Multiple Sclerosis (MS), evoked potentials (EP) studies appear to have lost their value, despite their ability to indicate the real-time status of the physiological system, and the nature of the lesion [1-5]. Indeed, EPs are rarely mentioned in the current literature, and are not found as frequently as MRI in clinical studies. The measurement of EPs is noninvasive, inexpensive, easy to access and implement, and provides clear numerical values to evaluate signal propagation in time and space in cases of suspected MS [6]. In this study, we investigated the diagnostic utility of EPs and their correlation with MRI findings in our patients who were evaluated for suspected MS. In this study, the medical records at first admission of 100 patients who were evaluated for suspected MS were analyzed retrospectively. The correlations of evoked potentials with clinical and MRI findings were analyzed. The EPs tests included: visual evoked potential (VEP), median nerve somatosensory evoked potential (median SEP), tibial nerve somatosensory evoked potential (tibial SEP), and brainstem auditory evoked potential (BAEP). A Keypoint (Alpine, Denmark) instrument was used to record the EPs. All MRI images were obtained with a 1.5 T super-conductive magnet (Philips Achieva) with a standard head coil of 8-16 channels. Transverse T1 and T2- weighted, transverse FLAIR, Coronal T2-weighted, and contrast T1 sequences were obtained, according to the conventional MRI protocol.
Authors and Affiliations
Gönül Vural, Şadiye Gümüşyayla, Hesna Bektaş, Gülsüm Akdeniz, Orhan Deniz
Keywords
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- EP ID EP587339
- DOI 10.26717/BJSTR.2018.10.001915
- Views 151
- Downloads 0
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