Author/Editor		Denišlič, M
Title		Dilemmas in the diagnosis of multiple sclerosis
Type		članek
Source		In: Vodušek DB, editor. Proceedings of the Symposium on multiple sclerosis with the 11th dr. Janez Faganel memorial lecture; 1995 Oct 6-7; Ljubljana. Ljubljana: University institute of clinical neurophysiology,
Publication year		1995
Volume		str. 34-41
Language		eng
Abstract		Recently, the precocious diagnosis of multiple sclerosis has been increased by the development of a battery of tests to highlight the evidence of demyelinating lesions in central nervous system. The author discusses the gold standard/diagnostic criteria in establishing the diagnosis of multiple sclerosis. Despite of the large spectrum of diagnostic tests the diagnosis of multiple sclerosis requires the synthesis of data by a clinician. The use of magnetic resonance imaging as the most sensitive imaging procedure in discovering the silent lesions in the central nervous system present the new era in the early diagnosis of multiple sclerosis. In spite of a sensitive neuroradiological techniques multimodal evoked potentials, CSF findings, quantitative sensorymetry and evaluation of autonomic nervous system may play an important role in the demonstration of disseminated white matter changes. The author raises the questions regarding the indications of multimodal evoked potentials compared to magnetic resonance imaging. With more widespread availability, magnetic resonance would certainly be the investigation of first choice. However, for the detection of lesions in the optic nerves, which appear in a high percentage of patients with multiple sclerosis, the use of visual evoked potentials would continue to remain the test of choice. Evaluating the patients with isolated optic neuritis the similar sensitivity of motor evoked potentials as well as the method of magnetic resonance was established. In those patients the other types of evoked potentials - somatosensory and brainstem acoustic evoked potentials - expressed less sensitivity comparing with motor evoked potentials and magnetic resonance in the detection of disseminated lesions. Especially in patients with restricted spinal cord lesions the role of multimodal evoked potentials will be superior to the new neuroimaging methods.(Truncated)
Descriptors		MULTIPLE SCLEROSIS NEUROLOGIC EXAMINATION