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The initial diagnosis of multiple sclerosis: Clinical impact of magnetic resonance imaging
Author(s) -
Gebarski Stephen S.,
Gabrielsen Trygve O.,
Gilman Sid,
Knake James E.,
Latack Joseph T.,
Aisen Alex M.
Publication year - 1985
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410170509
Subject(s) - multiple sclerosis , magnetic resonance imaging , medicine , cerebrospinal fluid , brainstem , radiology , lesion , pathology , central nervous system disease , psychiatry
Thirty patients in whom the initial diagnosis of multiple sclerosis was clinically entertained underwent cranial magnetic resonance imaging (MRI) in close temporal relationship to cranial x‐ray computed tomography (CT), electrodiagnostic studies (visual evoked responses, brainstem auditory evoked responses, and somatosensory evoked responses), and cerebrospinal fluid analyses (Oligoclonal bands, myelin basic protein, and IgG/albumin ratio). In 26 of the 30 patients, MRI demonstrated lesions consistent with multiple sclerosis that corresponded, at least in part, with the clinically expected neuroanatomical lesion distribution. Two of the 4 patients with normal MRI had normal electrodiagnostic studies and cerebrospinal fluid analyses, and the other 2 had a single abnormal or equivocal electrodiagnostic study. All 26 patients with abnormal MRI had at least one other abnormal laboratory test. CT revealed only the largest lesions, and in the patients with abnormal CT, MRI demonstrated even more lesions. MRI, in this limited series, proved to be a strong tool in the initial diagnosis of multiple sclerosis; it may prove to be the single best test, with a sensitivity exceeding that of electrodiagnostic studies and cerebrospinal fluid analysis.