There is still a role for the blink reflex in the diagnosis and follow-up of multiple sclerosis

• At present, the diagnostic criteria for multiple sclerosis (MS) do not include neurophysiological testing.
• The blink reflex is a sensitive test for MS and abnormalities are related to disease duration, disability, and lesions in the brainstem.
• Neurophysiological methods should be included for diagnosis and follow-up of patients with MS.

ObjectiveThe evolution of the diagnostic criteria for multiple sclerosis (MS) has essentially evolved to clinical manifestations and magnetic resonance imaging. Inexpensive, quick to apply, non-invasive, quantitative and reliable neurophysiological tests are rare in daily practice and absent in clinical trials.MethodThe blink reflex was assessed in 50 patients with remitting-relapsing MS (RRMS) and 100 matched controls.ResultsPatients with RRMS had abnormalities in the blink reflex waves in relation to controls. If only RRMS patients were considered, these abnormalities were more pronounced in patients with longer disease duration, higher disability and for those with clinical or image lesions in the brainstem.ConclusionNeurophysiological tests, such as the blink reflex, can be used for helping the diagnosis and follow-up of patients with RRMS, since the reflex can identify dissemination in time and in space in a clear and quantitative manner.SignificancePotential good methods for diagnosis and follow-up of MS should be considered for clinical trials and daily practice.