Summary
Tone pips of suprathreshold intensities elicit an acoustic nerve response (I) and six low amplitude brainstem potentials (II–VII) during the initial 10 ms. Seven waves were studied in 40 control subjects and 5 waves (I–V) in 47 patients with MS. The results suggest involvement of the auditory pathway of 24 of 27 patients in the clinically “definite”, of 5 of 9 cases in the “probable” and in none of 5 patients in the “possible” MS groups. EAEPs were normal in 6 cases with a spinal form with one exception where changes of potential were indicative of a midbrain lesion. Dysfunction within the acoustic pathway was observed at the level of the acoustic nerve and in the medulla oblongata, pons and midbrain. The significance of the bilateral EAEP abnormalities found in some patients at different levels is discussed with regard to a polytopic location of the underlying lesion.
Zusammenfassung
Nach einem kurzen Tonimpuls (tone pip) lassen sich in den ersten 10 ms eine Antwort vom N. acusticus und 6 im Nanovoltbereich liegende Hirnstammpotentiale auslösen. 7 Komponenten wurden bei 40 Normalpersonen und 5 Komponenten (I–V) bei 47 MS-Patienten untersucht. Bei „eindeutiger“ MS war in 24 von 27 Fällen ein Befall der Hörbahn nachweisbar. Bei der „wahrscheinlichen“ Form sahen wir in 5 von 9 Fällen und bei der „fraglichen“ MS bei keinem der Patienten Veränderungen. Bei der „spinalen“ Form waren die frühen akustisch evozierten Potentiale (FAEP) bis auf einen Fall mit Hinweis auf eine Mittelhirnschädigung normal. Schädigungen konnten in allen Hirnstammbereichen (Medulla oblongata, Pons und Mittelhirn) nachgewiesen werden. Ein Befall von peripheren Anteilen der Hörbahn (N. acusticus) mit intermittierenden und bleibenden Veränderungen der 1. Reizantwort ließ in 7 Fällen an eine extramedulläre Dissemination denken. Bei Patienten mit Befall beider Hörbahnen aber in verschiedenen Höhen wird die Möglichkeit einer Aussage in Richtung einer polytopischen Lokalisation in Aussicht gestellt.
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This work includes part of a thesis of E. Schäfer (University of Mainz)
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Maurer, K., Schäfer, E., Hopf, H.C. et al. The location by early auditory evoked potentials (EAEP) of acoustic nerve and brainstem demyelination in multiple sclerosis (MS). J. Neurol. 223, 43–57 (1980). https://doi.org/10.1007/BF00313139
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DOI: https://doi.org/10.1007/BF00313139