Predictive role of evoked potential examinations in patients with clinically isolated optic neuritis in light of the revised McDonald criteria

• Published in: Multiple sclerosis Vol. 14; no. 4; pp. 472 - 478
• Main Authors: Simó, Magdolna, Barsi, Péter, Arányi, Zsuzsanna
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.05.2008; Arnold; Sage Publications Ltd
• Subjects: Adult; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disability Evaluation; Electrodiagnosis. Electric activity recording; Evoked Potentials, Motor; Evoked Potentials, Somatosensory; Evoked Potentials, Visual; Female; Follow-Up Studies; Humans; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Multiple Sclerosis - diagnosis; Multiple Sclerosis - physiopathology; Nervous system; Neurology; Optic Neuritis - diagnosis; Optic Neuritis - physiopathology; Predictive Value of Tests; Prognosis; Sensitivity and Specificity; Severity of Illness Index; McDonald criteria; MRI; multiple sclerosis; evoked potentials; optic neuritis; Human; Nervous system diseases; Multiple sclerosis; Optic nerve; Optic neuritis; Electrophysiology; Nuclear magnetic resonance imaging; Inflammatory disease; Eye disease; Cranial nerve disease; Visual pathway; Optic nevritis; Evoked potential; Light; Central nervous system disease; Degenerative disease
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458507085061

To analyse the sensitivity and role of somatosensory and motor evoked potentials (EP) in patients with a first episode of clinically isolated optic neuritis (ON) in predicting the development and course of multiple sclerosis (MS), 27 patients with ON underwent EP and magnetic resonance imaging (MRI) examinations at presentation. Follow-up MRI scans were also performed (mean: 20, range: 4—48 months). It was found that 2/27 patients did not fulfill the MRI (McDonald) and clinical criteria of MS upon follow-up and also had normal EP results. Abnormal EP results were found in 6/27 patients and all of them had follow-up MRI results fulfilling the revised McDonald criteria of MS; 4/6 patients in this group were also diagnosed as clinically definitive MS. The majority, 19/27 patients had normal EP results, but went on to develop MS based on follow-up MRI results and McDonald criteria. Of these patients, however, only 3/19 converted to clinically definitive MS as well. The baseline MRI was abnormal in similar proportions (4/6 and 12/19) in these last two groups of patients. Thus, abnormal EP examinations at the first episode of ON can be considered as a predictive factor only for the earlier clinical conversion to MS — in this respect, however, being more sensitive than the initial MRI — and as such they may contribute to the delineation of the patient group who may benefit from early immunomodulatory treatment. They do not however have a predictive value for the development of MS itself as diagnosed by the McDonald criteria. Multiple Sclerosis 2008; 14: 472—478. http://msj.sagepub.com