Brain-stem involvement in multiple sclerosis: a comparison between brain-stem auditory evoked potentials and the acoustic stapedius reflex

Abstract

Brain-stem auditory evoked potentials (BAEPs) and the acoustic stapedius reflex (ASR) were recorded in 68 patients with definite, probable and possible multiple sclerosis (using the definitions of McAlpine). The high incidence of abnormal results, 68% and 60%, respectively, pointed to the diagnostic value of these two measures in detecting brain-stem dysfunction. Combination of the methods increased the diagnostic yield to 85%. Since in part the same brain-stem generator sites underlie BAEPs and the ASR, it was considered that a study of their correlation might serve to increase the reliability and validity of these techniques. There was 71% agreement overall between results from the two measures. Furthermore, 72% of the joint BAEP and ASR abnormalities corresponded in detection of the brain-stem lesion site. It was concluded that the combined approach may supply powerful, complementary information on brain-stem dysfunction, which may aid in establishing the diagnosis of multiple sclerosis.

Patterns of Auditory Abnormality in Multiple Sclerosis

“…The present results of combinations of test outcomes are in remarkably good agreement with the analogous data of Kofler et al (1984) for ABR and AR. These investigators found that the combination 285 SEMINARS IN HEARING-VOLUME 11, NUMBER 3 August 1990 of ABR or AR identified 91 percent of their definite MS group compared to 82 percent in the present study.…”

“…These investigators found that the combination 285 SEMINARS IN HEARING-VOLUME 11, NUMBER 3 August 1990 of ABR or AR identified 91 percent of their definite MS group compared to 82 percent in the present study. Similarly, Kofler et al (1984) found that the combination of ABR and AR abnormality occurred in 45 percent of their definite MS group compared to 40 percent in the present study.…”

Die Generatoren der AEP-Wellen II-III

“…Nach Borg (1973) läuft die SR-Afferenz den N. akustikus zum NC, von dort zum Komplex der 00 und von dort weiter zum Fazialiskern. Bei 20 MS-Patienten war em Ausfall des gegenseitigen Stapediusreflexes mit Veränderungen der Welle III verbunden (Kofler et al, 1984). Alle diese Befunde sind mit einer Entstehung der Welle III im 00-Komplex oder im CTZ vereinbar, nicht dagegen mit einer Entstehung im N. cochlearis, weil bei Herdbildung dort kaum eine Abduzensparese erwartet werden kann und vor allem auch zugleich der homolaterale SR ausgefallen sein mü&e. Die Frage, ob in der Höhe der 00 auch die kortiko-bulbären Fasern zurn Fazialis geschadigt werden können, lost sich, wenn entsprechende Hinweise vom Affen auf den Menschen ubertragen werden.…”