Visual evoked responses in the diagnosis and management of patients suspected of multiple sclerosis.

Averaged visual evoked responses to pattern reversal stimuli have been recorded in 54 control subjects, 51 patients with multiple sclerosis, and 55 patients with other neurological diseases which might involve the visual apparatus. The latency to the peak of the major positive potential in normal subjects under the age of 60 was 104 msec or less (mean 90-5 msec+3 SD). The latency of the VER was prolonged above this value in one or both eyes in 67 per cent of the patients with multiple sclerosis (in 84 per cent of those with definite multiple sclerosis, in 83 per cent of those with probable multiple sclerosis, and in 21 per cent of those with possible multiple sclerosis). The latency of the VER was also prolonged in 25 percent of those with an acute spinal cord lesion of unknown cause; in 46 per cent of those with an isolated brain-stem lesion unknown cause; and in 49 per cent of patients presenting with a progressive spastic paraparesis. The extra delay in latency varied from a few msec to as much as a 100 msec. In patients with multiple sclerosis, a delayed VER was found in the affected eye in all with a previous history of optic neuritis, and in 47 per cent of those with no such history....