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Multiple Sklerozis’li Olgularda BAEP ve MRI Bulgularının Karşılaştırılması

Comparison of BAEP and MRI Findings in Patients with Multiple Sclerosis

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Abstract (2. Language): 
Purpose: Brainstem structure is frequently involved in multiple sclerosis (MS). In this study, we aimed to compare the sensitivities of BAEP and MRI in detecting the brainstem lesions in the cases diagnosed as definitive MS with and without brainstem involvement. Method: A total of 50 cases (35 females and 15 males) with definitive MS with their history and clinical evaluation (mean age: 33.9±9.59, range: 18-57 years) were included in this study. Patients with brainstem involvement as group 1 and cases without brainstem involvement as group 2 were separated into two groups. Thirty-five similarly agematched healthy subjects were taken as the control group. MRI and BAEP were performed in the cases included in this study. I., III. and V. wave peak latencies, and I-III, I-V, and III-V inter peak latencies (IPLs) were determined. Results: Of the total 50 MS patients, 26% had plaques in brainstem in the MRI and 88% had abnormalities in BAEP evaluation. BAEP abnormalities were V. wave absolute latency in 60%, III-V IPL in 74% and in 62% I-V IPLs of patients. In the comparison of patients and controls, the V. wave absolute latency and III-V, I-V IPLs were significantly prolonged in the patients (p < 0.001 for all). Brainstem plaques in MRI were obtained in 33.3% and BAEP abnormalities were recorded in 83.3% patients in group 1. Abnormalities were determined in BAEP of the 100% MS cases in group 2; and additionally 7.1% cases showed a plaque in brainstem in MRI. In the comparison of MS patients with and without brainstem involvement, the differences were significant between in terms of BAEP and MRI findings (p < 0.001 for all). Conclusion: Our results indicated that BAEP is relatively more sensitive than MRI in the detection of brainstem dysfunction, with or without any clinical findings in MS cases.
Abstract (Original Language): 
Amaç: Multiple Sklerozis’de (MS) beyin sapı yapıları sıklıkla tutulmaktadır. Bu çalışmada beyin sapı tutuluşu olan ve olmayan kesin MS tanısı almış olgularda beyin sapı tutuluşunu belirlemede BAEP ve MRI’nin duyarlılıklarının karşılaştırılması amaçlandı. Yöntem: Öykü ve/veya klinik değerlendirmeyle kesin MS tanısı alan 50 olgu (35 kadın, 15 erkek) çalışmaya alındı (ortalama yaş: 33.9±9.59, yaş aralığı: 18-57 yıl). Olgular klinik olarak beyin sapı tutuluşu olan (grup 1) ve olmayan (grup 2) olmak üzere iki gruba ayrıldı. Çalışmaya alınan olgularda MRI ve BAEP kayıtlandı. BAEP parametreleri yaş olarak benzer 35 sağlıklı kontrolle karşılaştırıldı. I., III., ve V. dalga latansları ile I-III, III-V, I-V interpik latansları (IPL) belirlendi. Sonuçlar: Elli MS’li hastanın %26’sında MRI’de beyin sapında plak; %88’inde BAEP parametrelerinde anormallik belirlendi. BAEP anormallikleri %60 V. dalga latansı ve %74 III-V, %62 I-V IPL uzama şeklindeydi. Olgular ve kontrollerin karşılaştırılmasında V. dalga latansı ve III-V, I-V IPL’lar olgularda anlamlı şekilde uzamıştı (p < 0.001, her üçü için ). Grup 1’de olguların %33.3’ünde MRI’de beyin sapında plak bulundu ve %83.3’ünde BAEP’te anormallik kayıtlandı. Grup 2’deki MS’lilerin %100’ünün BAEP’lerinde anormallik belirlendi ve %7.1’i MRI’de beyin sapında plak gösterdi. Beyin sapı tutuluşunu olan ve olmayan MS’li olguların karşılaştırılmasında BAEP ve MRI bulguları arasında farklılıklar anlamlıydı (p < 0.001, her üçü için). Yorum: Sonuçlarımız, beyin sapı tutuluşu olan veya olmayan MS’li olgularda beyin sapı disfonksiyonunu belirlemede BAEP’in MRI’ya göre rölatif olarak daha duyarlı olduğunu göstermektedir.
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