Bovine spongiform encephalopathy: diagnostic significance of vacuolar changes in selected nuclei of the medulla oblongata.

The adequacy of a histopathological diagnosis of bovine spongiform encephalopathy (BSE) based exclusively on observations of neuroparenchymal vacuolation in three specific neuroanatomic nuclei was tested by using a standard coronal section of medulla oblongata cut at the obex. The agreement between the observations and the definitive histopathological diagnosis was assessed in each of 684 bovine brains - 563 confirmed cases of BSE, 20 with changes which did not diagnose BSE conclusively and 101 in which the lesions of BSE were not detected. When the assessment was confined to the solitary tract nucleus and the spinal tract nucleus of the trigeminal nerve a positive result was obtained in 99.6 per cent of confirmed cases of BSE and only 1 per cent of brains in which lesions of BSE were not detected gave a false positive result. Thus an initial examination of the single section, together with an examination of representative areas of the rest of the brain when no unequivocal lesion was found, provided a satisfactory method for the routine diagnosis of BSE.