7. Evoked potentials in diagnosis and prognosis of multiple sclerosis

• Published in: Clinical neurophysiology 2014-05, Vol.125 (5), p.e27-e27
• Main Author: Štětkářová, I
• Format: Article
• Language: English
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2013.12.045

Objective Evoked potentials (EP) are functional neurophysiological methods that have been used in multiple sclerosis (MS) especially in its early diagnosis. Recently, multimodal EPs appears to be a prognostic factor for disease progression. Methods The review is based on a literature search in PubMed and the author’s long experience of neurophysiological diagnostics. Results Visual evoked potential (VEP) are preferentially used in early diagnosis of MS. They are highly sensitive to detect subclinical optic neuritis more than magnetic resonance. Somatosensory (SEP) and motor (MEP) evoked potentials can reveal subclinical lesions in the central nervous system and could be a supplementary diagnostic tests for sensory and motor system disturbances. MEP abnormalities correlate with the degree of motor impairment and disability assessed by EDSS. Abnormal multimodal EPs (”positive EP score”) at the first session are worse prognostic factor. Low and stable EP scores along with stable EDSS identify a ”benign” form of RS. The assessment of the disease progression and/or monitoring of the therapeutic effects have some limitations, e.g. abnormal response persists even in relative inactivity of the disease and it’s localization is non-specific. The sensitivity of EPs increases with the length of the tested neural pathways and with used EP modalities. Conclusion Evoked potentials are highly sensitive in revealing ”silent lesions” especially at the beginning of MS and/or when no obvious neurological symptoms occur. Multimodal evoked potentials have indisputable benefit of prognostic value to determine non-responders, ”benign” course of the disease and patients with significant disease progression. Supported by Research Project of Charles University PRVOUK P34, Czech Republic.