SENSITIVITIES AND PREDICTIVE VALUES OF PARACLINICAL TESTS FOR DIAGNOSING MULTIPLE-SCLEROSIS

The sensitivities and predictive values of visual, somatosensory, and brain auditory evoked potentials (EPs), cerebrospinal fluid oligoclona l banding (CSF-OB) and magnetic resonance imaging (MRI) were evaluated for the early diagnosis of clinically definite multiple sclerosis (CD MS). Paraclinical evidence of asymptomatic lesions allows a diagnosis of CDMS. Eighty-two patients in whom MS was suspected but diagnosis of CDMS was not possible entered the study prospectively. Paraclinical e xaminations were performed at entry. Patients were examined and underw ent EPs every 6 months, and MRI yearly. After a mean follow-up of 2.9 years, 28 patients (34%) had developed CDMS (McDonald-Halliday criteri a). The initial MRI was strongly suggestive of MS in 19 of these (68%) , while 27 (96%) had at least one MS-like abnormality in the initial M RI. CSF-OB and EPs had lower sensitivities. CDMS developed during foll ow-up in 19 of the 36 patients (53%) who had an initial MRI strongly s uggestive of MS but in only 1 of the 25 who had normal MRI when first studied. These results support previous conclusions that MRI is the mo st sensitive test for detecting white matter asymptomatic lesions, and the most predictive for the diagnosis of CDMS.