The Early Diagnosis of Multiple Sclerosis

An outline of modern views on the aetiology of multiple sclerosis is followed by a discussion of diagnosis. Examination of the cerebrospinal fluid, visual evoked potentials, and other electrophysiological tests are considered. The special problems of optic neuritis, spastic paraparesis, and psychological disorder receive more detailed attention. It is concluded that while the supplementary tests are valuable the diagnosis remains essentially clinical.

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Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis

Journal of Neuro-Ophthalmology ◽

10.1097/wno.0000000000000704 ◽

2018 ◽

Vol 38 (3) ◽

pp. 350-357 ◽

Cited By ~ 5

Author(s):

Letizia Leocani ◽

Simone Guerrieri ◽

Giancarlo Comi

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Evoked Potentials ◽

Visual Evoked Potentials ◽

Visual Evoked

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Predictive value of optical coherence tomography, multifocal visual evoked potentials, and full-field visual evoked potentials of the fellow, non-symptomatic eye for subsequent multiple sclerosis development in patients with acute optic neuritis

Multiple Sclerosis Journal ◽

10.1177/1352458520917924 ◽

2020 ◽

pp. 135245852091792 ◽

Cited By ~ 2

Author(s):

Gorm Pihl-Jensen ◽

Benedikte Wanscher ◽

Jette Lautrup Frederiksen

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Evoked Potentials ◽

Visual Evoked Potentials ◽

Predictive Value ◽

Inner Plexiform Layer ◽

Optical Coherence ◽

Full Field ◽

Visual Evoked

Background: Diagnosis of multiple sclerosis (MS) may sometimes be ascertained at the time of optic neuritis (ON) but other times require the advent of new disease activity. Objectives: The aim of this study was to examine the predictive value of optical coherence tomography (OCT) and visual evoked potential (VEP) measurements of the non-symptomatic, fellow eye of ON patients, for conversion to MS. Methods: This is a prospective cohort study in patients with acute ON. OCT thickness measurements of peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell layer–inner plexiform layer (GCLIPL), and multifocal (mf) VEP and full-field (ff) VEP, were performed. Univariate and multivariate Cox regression examined the value of predictors for the conversion to MS. Results: A total of 79 unilateral, acute ON patients, with no MS diagnosis or prior demyelination, were included. Of which, 28 patients developed MS during follow-up. Inferonasal GCLIPL, mean GCLIPL, and pRNFL thickness significantly predicted MS development in multivariate analysis (hazard ratio (HR) = 0.922–0.939, p = 0.0172–0.021). MfVEP mean latency (HR = 1.052, p = 0.006) only predicted MS conversion in univariate analysis. No significant predictive value was shown for the other parameters ( p > 0.2). Conclusion: While both mfVEP and OCT are useful tools in the evaluation of acute ON patients, only OCT measurements of fellow eyes may serve as an independent predictor of MS development.

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