Brain stem magnetic resonance imaging and evoked potential studies of symptomatic multiple sclerosis patients

G. Comi, M. Filippi, V. Martinelli, G. Scotti, T. Localelli, S. Medaglini, F. Triulzi, M. Rovaris, N. Canal

Research output: Contribution to journalArticlepeer-review

Abstract

In this study we evaluated the sensitivity of neuroradiological and neurophysi-ological tests for detecting brain stem (BS) lesions in multiple sclerosis patients, since the recent introduction of the gradient motion rcphasing technique has markedly increased the image quality of magnetic resonance imag-ing(MRI). From 50 MS patients (33 women and 17 men; mean age 35.9 ± 8.3 years; mean duration of the disease 7.2 ± 4.1 years) with clinical signs of BS involvement, brain MR1. BS auditory evoked potentials (BAEPs). and left and right median somatosensory evoked potentials (mSEPs) were obtained. BS MRI lesions were detected in 41 patients (82%); in 14 cases they were located in the medulla oblongata, in 55 in the pons, and in 24 in the midbrain. Single lesions were present in 20 patients, while two or more BS lesions were demonstrated in 21 patients; 30 patients had at least one lesion located close to the inner or the outer cerebrospinal fluid border. BAEPs were abnormal in 19 of the 50 patients (38%). and BS components of mSEPs were abnormal in 15 of 46 (33%). With combined use of these neurophysiological techniques, BS abnormalities were revealed in 24 patients (48%). Only 1 patient had neurophysiological BS abnormalities and normal MRI. Moreover, there was a good correlation (74%) between the clinical and MRI BS findings in the 23 patients with signs referable to focal neurological BS lesions. The concordances considering clinical and evoked potential reports were positive, but less marked. Our data demonstrate that a thin-slice MRI examination using the gradient motion rephasing technique is far more sensitive than BAEPs or mSEPs for detecting BS-demyelinating lesions.

Original languageEnglish
Pages (from-to)232-237
Number of pages6
JournalEuropean Neurology
Volume33
Issue number3
DOIs
Publication statusPublished - 1993

Keywords

  • Brain magnetic resonance imaging
  • Brain stem auditory evoked potentials
  • Median somatosensory evoked potentials
  • Multiple sclerosis, Brain stem involvement

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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