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Occult Fifth Nerve Dysfunction In Multiple Sclerosis

Published online by Cambridge University Press:  18 September 2015

Andrew Eisen ,
Donald Paty ,
Sherrill Purves  and
Maureen Hoirch
Andrew Eisen*
Affiliation:
Division of Neurology (Department of Medicine) of the Vancouver General Hospital and The University of British Columbia
Donald Paty
Affiliation:
Division of Neurology (Department of Medicine) of the Vancouver General Hospital and The University of British Columbia
Sherrill Purves
Affiliation:
Division of Neurology (Department of Medicine) of the Vancouver General Hospital and The University of British Columbia
Maureen Hoirch
Affiliation:
Division of Neurology (Department of Medicine) of the Vancouver General Hospital and The University of British Columbia
*
Diagnostic Neurophysiology (EMG), Vancouver General Hospital, 855 West 12th Avenue, Vancouver, B.C. V5Z 1M9
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Somatosensory evoked potentials (SEPs) were recorded following trigeminal nerve stimulation in 25 normal subjects. Mucosal stimulation of the lip resulted in a reduced stimulus artefact. The three initial peaks, N13, P19, and N30, measured respectively 12.8 ± 0.9 S−3, 19.3 ± 1.4 S−3 and 28.6 ± 1.7 S−3. Blink reflex studies were also performed in most of these subjects. In 41.4% of 29 patients with established or suspected multiple sclerosis, the trigeminal SEP was abnormal. Additional use of the blink reflex raised the overall incidence of trigeminal nerve dysfunction to 51.7%. None of the patients had clinical evidence of fifth nerve involvement either historically or on examination. Four of seven patients with progressive spinal MS and two patients whose only deficit was that of optic neuritis, had abnormal trigeminal SEPs. It is concluded that occult involvement of the pontine fifth nerve structures occurs frequently in MS despite the rarity of corresponding clinical findings. The trigeminal SEP is a useful additional neurophysiological method.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 8 , Issue 3 , August 1981 , pp. 221 - 225
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

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