CONTRIBUTION OF MRI, MULTIMODAL EVOKED-POTENTIALS AND CSF CHANGES TO THE DIAGNOSIS OF MULTIPLE-SCLEROSIS

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 seperately. 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.