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Loren A. Rolak, MD; Tetsuo Ashizawa, MD
Baylor College of Medicine Houston

JAMA. 1983;250(24):3281-3282.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The report by Berger and Sheremata¹ documented the dangers of the hot bath test in diagnosing multiple sclerosis. In support of their results, other limitations of this test, not addressed by their report, need to be emphasized. (1) The hot bath meets few criteria for a good clinical test. Its validity is uncertain; the assumption that the appearance of new neurological signs represents an underlying subclinical demyelinating lesion is unproved and is challenged by the finding that 18% of normal controls display new, abnormal neurological signs during the test.² Authors disagree on how sensitive and specific it is,^2-4 and up to 55% of patients with neurological diseases other than multiple sclerosis have a positive test result.² It has never been standardized (ie, appearance of what signs after what elevation of temperature for how long a time?), nor has its reproducibility ever been determined. . . . [Full Text PDF of this Article]

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