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Predictive role of evoked potential examinations inpatients with clinically isolated optic neuritis inlight of the revised McDonald criteria

¹ Department of Neurology, Semmelweis University, Balassa u. 6, 1083 Budapest, Hungary
² MRI Research Center, Semmelweis University, Balassa u. 6, 1083 Budapest, Hungary

^* To whom correspondence should be addressed.

	Abstract

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 multiplesclerosis (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: 448 months). It was found that 2/27 patients did not fulfill the MRI (McDonald) and clinical criteria of MS upon followup and also had normal EP results. Abnormal EP results were found in 6/27 patients and all of them hadfollow-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.

Key Words: evoked potentials; McDonald criteria; MRI; multiple sclerosis; optic neuritis

First published on January 21, 2008, doi:10.1177/1352458507085061

Multiple Sclerosis 2008;14:472.

A more recent version of this article appeared on May 1, 2008


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