Email this article Multimodal evoked potentials and transcranial magnetic stimulation in diagnostics of children with encephalitis, acute disseminated encephalomyelitis and multiple sclerosis
- Authors: Skripchenko E.Y.1,2, Klimkin A.V.3, Voitenkov V.B.3, Skripchenko N.V.1,3, Surovtseva A.V.3
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Affiliations:
- Saint Petersburg State Pediatric Medical University
- Institute of Human Brain named after N.P. Bekhtereva, Russian Academy of Sciences
- Pediatric Research and Clinical Center for Infectious Diseases
- Issue: Vol 13, No 1 (2018)
- Pages: 20-33
- Section: AUTHENTIC ARTICLES
- Published: 10.04.2018
- URL: https://rjdn.abvpress.ru/jour/article/view/245
- DOI: https://doi.org/10.17650/2073-8803-2018-13-1-20-33
- ID: 245
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Abstract
Background. The growing incidence of such central nervous system disorders as encephalitis (EP), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) in pediatric population, similarity of their clinical manifestations at the onset, lack of universal diagnostic criteria and the risk of ADEM transformation into MS in the case of late diagnosis and inadequate treatment suggest the importance of this problem.
Objective: to evaluate diagnostic and prognostic value of multimodal evoked potentials and transcranial magnetic stimulation (TCMS) in children with EP, ADEM and MS.
Materials and methods. The study included 200 participants: 50 children with MS (mean age 14.0 ± 3.7 years), 50 children with ADEM (mean age 14.0 ± 3.5 years), 50 children with EP (mean age 12.0 ± 2.2 years) and 50 controls (mean age 14.0 ± 3.1 years). All patients underwent neurological examination, magnetic resonance imaging of the brain, diagnostic TCMS and assessment of visual evoked potentials, brainstem auditory evoked potentials, cognitive evoked potentials P300 to an auditory stimulus and somatosensory evoked potentials.
Results. We found that the P37–N45 amplitude 124 msec) is a risk factor for ADEM transformation into MS. The P100 latency >132 msec and lack of cortical evoked motor response from the m. abductor hallucis at MS onset indicate a high risk of disease progression and further development of disability
Conclusion. TCMS and assessment of multimodal evoked potentials (with estimating response amplitudes) allow determining the nature and severity of brain lesions, detecting subclinical dysfunction of the central nervous system, monitoring of the recovery processes and predicting outcomes in children with EP, ADEM and MS.
About the authors
E. Yu. Skripchenko
Saint Petersburg State Pediatric Medical University;Institute of Human Brain named after N.P. Bekhtereva, Russian Academy of Sciences
Email: fake@neicon.ru
Litovskaya St., Saint Petersburg 194100
9 Acad. Pavlova St., Saint Petersburg 197376
Russian FederationA. V. Klimkin
Pediatric Research and Clinical Center for Infectious Diseases
Email: fake@neicon.ru
9 Prof. Popova St., Saint Petersburg 197022 Russian Federation
V. B. Voitenkov
Pediatric Research and Clinical Center for Infectious Diseases
Email: fake@neicon.ru
9 Prof. Popova St., Saint Petersburg 197022 Russian Federation
N. V. Skripchenko
Saint Petersburg State Pediatric Medical University;Pediatric Research and Clinical Center for Infectious Diseases
Author for correspondence.
Email: snv@niidi.ru
Litovskaya St., Saint Petersburg 194100
9 Prof. Popova St., Saint Petersburg 197022
Russian FederationA. V. Surovtseva
Pediatric Research and Clinical Center for Infectious Diseases
Email: fake@neicon.ru
9 Prof. Popova St., Saint Petersburg 197022 Russian Federation
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