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The utility of evoked potentials in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD)


Multiple Sclerosis(MS)is primarily an inflammatory demyelinating disease of the central nervous system. With the identification of anti-aquaporin 4 (AQP4) antibodies, neuromyelitis optica spectrum disorder (NMOSD) was distinguished from MS. It has been reported that NMOSD is a different condition from MS in not only the clinical symptoms and laboratory data, but also in the pathological findings. The demyelination by immune cells including active T-cells has been reported as the pathogenesis of MS. On the other hand, the pathogenesis of NMOSD has been characterized by astrocytic damage. Previously, evoked potential (EP) findings characteristic of patients with MS have been reported. EP has been used to confirm the involvement of visual, auditory, sensory and motor pathways and to clarify clinically silent lesions in MS. But almost patients with NMOSD do not present subclinical abnormal findings in EP.  Collectively, our EP findings can allow us to distinguish NMOSD from MS in early differential diagnosis with greater confidence.