An evoked potential test measures the time it takes for nerves to
respond to stimulation. The size of the response is also measured. Nerves from
different areas of the body may be tested. Types of responses are:
Visual evoked response or potential (VER or
VEP), which is when the eyes are stimulated by looking at a test
Auditory brain stem evoked response or potential (ABER or
ABEP), which is when hearing is stimulated by listening to a test
Somatosensory evoked response or potential (SSER or SSEP),
which is when the nerves of the arms and legs are stimulated by an electrical
Each type of response is recorded from brain waves by using
electrodes taped to the head. The visual evoked response (VER) is the most
commonly used evoked potential test in the diagnosis of
multiple sclerosis (MS).
Living with multiple sclerosis means living with uncertainty. The course of the disease is very difficult for doctors to predict. Some people live with MS for years without suffering serious symptoms. Others may rapidly become disabled. Why the course of the disease varies so widely remains unclear. One thing is certain. Most people with MS experience periodic relapses, also called flare-ups or attacks. These can be mild or severe. They may show up in many different ways. Symptoms can include:
Conducting gel and electrodes are applied to the scalp. The
location will depend on the type of response being recorded. For example, when
VERs are recorded, the electrodes are applied to the rear (occipital region) of
the scalp over the brain areas that register visual stimuli.
Stimuli are delivered:
For VER by a strobe light or a screen with a
For ABER by clicking noises or a tone sent
For SSER by an electrical pulse at the wrist or
knee. This pulse is a mild electrical shock.
Responses from the electrodes are recorded. The time between the
stimulation and the response is called the latency, which indicates the speed
at which the nerves pass a signal.
Why It Is Done
This test may be used when MS is suspected and a neurological
examination alone does not provide enough evidence.
For a clear diagnosis of MS, the doctor has to find evidence that
multiple parts of the central nervous system are affected. When there are
symptoms clearly caused by MS lesions of the spine but no visual symptoms, the
visual response may be tested anyway. Abnormal results in such cases mean that
there are also areas of damage (MS lesions) on the brain.
Findings of this test may include the following.
The time between the stimulation and the nerve's response is
within the normal range.
Some people who are free from symptoms in the nerve area tested
will still have abnormal responses in that area.
Abnormal response times can also be associated with other
neurological diseases or with damaged optic nerves and eyes.
What To Think About
An evoked potential test typically takes half an hour or longer to