Visual evoked potentials in normal subjects and patients with multiple sclerosisKjær, Mogens
doi: 10.1111/j.1600-0404.1980.tb02998.xpmid: 7211154
Visual evoked potentials (VEPs) by checkerboard pattern‐reversal stimulation were recorded in 70 subjects aged 10–69 years and in 100 patients with definite, probable or possible multiple sclerosis (MS). Longer latencies and smaller amplitudes of the major positive component were found in male subjects, in old subjects and when the amplifier's band‐pass was narrowed. Subjects 10–14 years old had longer latencies and higher amplitudes than mature adults. Based on findings in the normal material, the following three criteria were used in evaluating the recordings from patients: the latency, the side difference in latencies and the ratio of amplitudes between the two sides of the major positive component with various limits for the two sexes and different age groups. The incidence of abnormal recordings was 85% for all the patients, 100% in 50 patients with definite, 70% in 50 patients with probable or possible MS, 73% in patients who had a history of spinal symptoms only, 98% if they had and 74% if they had not experienced optic neuritis. The incidence of abnormal findings increased with increasing duration of symptoms. All patients with visual acuity below 0.67 had abnormal VEPs. The high incidence of abnormal recordings confirmed the value of the test in establishing the diagnosis, and suggested that the use of different normative values for sex and age may increase the diagnostic yield without increasing the number of false positive findings.
Brain stem auditory and visual evoked potentials in multiple sclerosisKjær, Mogens
doi: 10.1111/j.1600-0404.1980.tb02999.xpmid: 7211155
The diagnostic value of the checkerboard pattern‐reversal visual evoked potential (VEP) and the random, low rate stimulated brain stem auditory evoked potential (BAEP) was compared in 99 patients with established or suspected multiple sclerosis (MS). In normal subjects examined by both techniques no abnormal recordings were found. In 49 patients with definite MS an incidence of abnormality was found in 100% of VEP and in 84% of BAEP recordings. In 50 patients with probable or possible MS an abnormal VEP was found in 70% and an abnormal BAEP in 50%. When the two examinations were combined, the diagnostic yield increased to 100 and 80%, respectively. 22 patients had only spinal symptoms; in these the VEP gave 73%, the BAEP 55% and the combination 82% abnormalities. The combination of the two techniques was found useful for demonstrating demyelinating lesions in the central nervous system, the diagnostic value being greatest when these lesions were clinically silent.
Recognizability of brain stem auditory evoked potential componentsKjær, Mogens
doi: 10.1111/j.1600-0404.1980.tb03000.xpmid: 7211156
In examining neurological patients suspected of having a brain stem lesion with brain stem auditory evoked potentials (BAEPs), a technique giving high amplitudes and/or maximal recognizability of most of the components was preferred. An increase of interstimulus intervals and stimulus strength and a widening of the band‐passes of the amplifier were found to increase the amplitudes and the recognizability in BAEPs from normal subjects and patients. A random monaural 75 dBHL stimulation with 230 msec intervals and frequency cut‐offs of the amplifier of 50–5,000 c/sec was chosen as the standard procedure. In normal subjects aged 10–69 years, a decrease in amplitudes was found with increasing age. Men older than 50 years had longer latencies than younger men. Women had shorter latencies and higher amplitudes than men. Waves I, III and V were recognized in all normal subjects; the recognizability of waves II, IV and VI was 94% or more in subjects younger than 50 years, 85–93% in the oldest subjects.
Homovanillic acid and 5‐hydroxyindoleacetic acid levels in cerebrospinal fluid of patients with progressive myoclonus epilepsyLeino, Eeva; MacDonald, Ewen; Airaksinen, Mauno M.; Riekkinen, Paavo J.
doi: 10.1111/j.1600-0404.1980.tb03002.xpmid: 6163302
The possibility of disturbed dopamine and serotonin metabolism in the progressive myoclonus epilepsy (PME) occurring in Finland (a type of PME without Lafora bodies) was examined. Both basal concentrations of HVA and 5‐HIAA in the CSF and their increase after oral probenecid administration were studied in 19 PME patients and in 19 age‐ and sex‐matched control patients. The control patients had grand mal epilepsy but not myoclonus or ataxia. The basal value of HVA was significantly reduced and that of 5‐HIAA was also slightly reduced in the PME patients as compared to the values of the epileptic controls or to those of 26 nonepileptic controls. The concentrations of HVA and 5‐HIAA also seemed to correlate with the severity of the PME. The most severely affected patients had generally the lowest values. After oral probenecid this trend was also seen when the increases of HVA and 5‐HIAA were expressed per μg CSF probenecid, i.e. the mildly affected PME group showed higher increases in response to probenecid than the most severely affected PME group. The PME patients had higher probenecid levels in the CSF than the epileptic controls.
Lymphocyte subpopulations in the cerebrospinal fluid and peripheral blood in multiple sclerosisCzłonkowska, Anna; Półtorak, Maciej; Cendrowski, Wojciech; Korlak, Janina
doi: 10.1111/j.1600-0404.1980.tb03003.xpmid: 6971037
Subpopulations of lymphocytes in the CSF and peripheral blood were studied in 30 patients with MS, 16 with other neurologcial diseases (OND) and 15 control subjects without any neurological abnormalities. In patients with relapse of MS, the absolute numbers of total lymphocytes, alpha‐naphthyl acid esterase (ANAE) positive, E‐rosette forming and bearing the “avid”FcIgG receptor lymphocytes were significantly increased in the CSF as compared with stable or slowly progressive MS patients, patients with other OND and control subjects. The relative number of ANAE‐positive cells was higher, and “avid”FcIgG receptor bearing cells lower in the CSF of all patients with MS than in the two other groups. The significance of the finding is unclear. The imbalance between lymphocyte subpopulations may reflect a primary defect in MS, or may be secondary, due to the presence of circulating immune complexes. In peripheral blood no substantial differences in lymphocyte behavior were observed between MS patients and other groups.