Earlier diagnosis of multiple sclerosis in children using multimodal evoked potentials

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Diagnostic criteria for multiple sclerosis (MS) in children with demyelinating brain disease require clinical or imaging findings of disease affecting multiple areas of the brain or spinal cord, and of disease occurring at more than one point in time. These criteria are referred to as requirements for evidence of “dissemination in time and space.” Children frequently lack dissemination in space early in the disease. Pohl et al collected their experience with multimodal evoked potential (EP) study results in 85 children with MS before their second episodes (confirming dissemination in space) and found that EP study abnormalities, especially in visual EPs, revealed clinically silent, and MRI- and ophthalmologic examination-negative, pathology. Multimodal EPs confirmed dissemination in space in almost one-half of patients.