[The diagnostic value of nuclear magnetic resonance tomography, multimodal evoked potentials and cerebrospinal fluid examination in multiple sclerosis]. / Die diagnostische Wertigkeit der Kernspintomographie, der multimodal evozierten Potentiale und der Liquoruntersuchung bei multipler Sklerose.

ABSTRACT

Seventy patients with multiple sclerosis (according to Poser's criteria) were clinically assessed and examined with MRI, multimodal evoked potentials (VEP, AEP, SSEP) and CSF analysis (transformed lymphocytes, IgG-Index, oligoclonal banding). In relation to the clinical criteria of McAlpine 40 patients had possible, 16 patients probable and 14 patients definite MS. 81% of the patients (73% possible MS, 94% probable MS, 93% definite MS) had multiple white matter lesions detected by MRI, 79% (78% possible MS, 94% probable MS, 64% definite MS) had an abnormal CSF profile and 67% (60% possible MS, 75% probable MS, 79% definite MS) abnormal results in multimodal EP testing. Of the patients who experienced only one attack (n = 40) 78% had multiple lesions on MRI, 88% had abnormal CSF-findings and 60% had pathologic EPs. Patients with two or more attacks showed in 87% multiple lesions on MRI, in 77% abnormal EPs and in 70% abnormal CSF findings. The number of abnormal MRI and EPs increases with the duration of the disease. 13 patients with a normal MRI were discussed separately. MRI is the most sensitive method in detecting the spatial pattern of disseminated lesions. To monitor the dissemination over time a careful clinical follow-up is still mandatory.