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Somatosensory evoked potentials and sensory involvement in multiple sclerosis: comparison with clinical findings and quantitative sensory tests

Department of Clinical Neurophysiology, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy, l.leocani{at}hsr.it

Vittorio Martinelli

Department of Neurology, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy

Maria Grazia Natali-Sora

Department of Neurology, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy

Marco Rovaris

Neuroimaging Research Unit, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy

Giancarlo Comi

Department of Clinical Neurophysiology, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy, Department of Neurology, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy, Neuroimaging Research Unit, University Vita-Salute, Scientific Institute Hospital San Raffaele, Milan, Italy

Sensory disturbances are one of the most common findings in patients with multiple sclerosis (MS). However, they are usually assessed at the standard neurological examination only. Q uantitative Sensory Tests (Q STs) for temperature and vibratory sense allow a more objective evaluation. In a group of 19 clinically definite MS patients, we compared vibratory and temperatur e thresholds with sensory symptoms or signs at clinical neurological examination and somatosensory evoked potentials (SEPs) at the four limbs. The frequency of abnormalities of clinical symptoms/signs, vibration threshold and median SEPs were 69%, 33% and 55%, respectively. C orrelation between degree of abnormality of SEPs and clinically assessed vibration sense (V) was statistically significant (P B-0.007; Spearmann rank coefficient), as well as between SEPs and vibration perceptio n threshold (P B-0.02). C linical evaluation of thermal sense did not show false positive results compared to quantitative thermal threshold, but false negative findings (35%). This study suggests that the combined use of vibration threshold and SEPs allows a better objectivation of sensory function, allowing the detection of subclinical abnormalities and possibly reducing the number of false positive results introduced by clinical assessment. Moreover, Q STs are to be preferred to clinical evaluation in the assessment of thermal sense, due to their superior sensitivity.

Key Words: evoked potentials • multiple sclerosis • quantitative sensory tests (Q STs) • somatosensory

Multiple Sclerosis, Vol. 9, No. 3, 275-279 (2003)
DOI: 10.1191/1352458503ms908oa


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