Sensitivity and specificity of visual evoked potentials for early diagnosis of demyelinating diseases

Introduction: International criteria are used for the diagnosis of multiple sclerosis (MS) and Isolated Clinical Syndrome (ACS), and Neuromyelitis Optica (NMO). PEVs are not included in any of them. We intend to analyse the sensitivity and specificity of visual evoked potentials in the initial diagnosis of MS, ACS, and NMO. Patients and methods: Descriptive, observational, retrospective study of patients treated for a first episode of RR-EM, NMO, or ACS. VEPs are performed during the study of the first episode, with and without ocular symptoms, between October 2012 and March 2019. Results: 142 patients with suspected demyelinating disease, 100 with disease. Of them, 61 women (61%), mean age: 38.82 years ± SD 4.6. Of the total, 83 with RREM, 6 NMO, 11 ACS. Of the 6 patients with NMO, 1 (16.66%) had altered VEPs; of 11 with ACS, 2 (18.18%) with altered VEP; Of the 83 patients with RR-MS, 45 patients (54.21%) had altered VEP. The sensitivity and specificity of visual evoked potentials in MS was 92.86% and 84.74%, respectively. In NMO, the sensitivity was 16.66%, and the specificity was 93.34%. In ACS, the sensitivity was 18.18%, and the specificity was 96.94%. Conclusion: The sensitivity of VEP in our series is slightly higher than other series published in optic neuritis in RR-MS, being very low in patients with NMO and ACS. However, the very high specificity of the test in these variants can help its diagnosis. These data should be corroborated in larger series. Resumen: Introducción: Para el diagnóstico de esclerosis múltiple (EM) y síndrome Clínico Aislado (SCA) y Neuromielitis óptica (NMO) se utilizan los criterios internacionales. En ninguno de ellos no se incluyen los PEV. Nos proponemos analizar la sensibilidad y especificidad de los potenciales evocados visuales en el diagnóstico inicial de EM, SCA y NMO. Pacientes y métodos: Estudio descriptivo, observacional, retrospectivo, de pacientes atendidos por primer brote de EM-RR, NMO ó SCA. Se realizan los PEV durante el estudio del primer episodio, con y sin clínica ocular, entre Octubre 2012 y Marzo 2019. Resultados: 142 pacientes con sospecha de enfermedad desmielinizante, 100 con enfermedad. De ellos, 61 mujeres (61%), media de edad: 38,82 años +/-DE 4.6. Del total, 83 con EM-RR, 6 NMO, 11 SCA. De los 6 pacientes con NMO, 1 (16,66%) tenía los PEV alterados; de 11 con SCA, 2 (18,18%) con PEV alterados; de los 83 pacientes con EM-RR, 45 pacientes (54,21%) con PEV alterados. La sensibilidad y especificid