Visual field plasticity in a female with right occipital cortical dysplasia

Brain plasticity refers to its ability to recover after damage. Visual field plasticity is not well recognized. We report a 12-year-old female who first presented with recurrent seizures and was subsequently found to have a large, right occipital cortical dysplasia on magnetic resonance imaging. Her visual field by Goldmann perimetry was totally normal. Visual-evoked potential studies revealed the left hemifield P100 response was detected maximally at the right temporal and parietal regions. A weak but reproducible right hemifield P100 response was located at the right medial skull base. Functional magnetic resonance imaging with flashlight stimulation revealed cerebral activity mainly at the right posterior temporal and parietal lobes and left occipital lobe. These studies suggested that the left hemifield function was located at the right posterior temporal and parietal lobes. The left occipital lobe may also have been reorganized, with a P100 vector pointing out from its inferiomedial base. We reviewed other related reported cases. We believe that visual-evoked potential studies and visual functional magnetic resonance imaging should be performed more liberally for recognition of visual field plasticity.