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Flash and pattern-reversal visual evoked potential abnormalities in infants and children with cerebral blindness
Y Frank1, D Kurtzberg, J A Kreuzer
1Cornell University Medical College, Division of Pediatric Neurology, North Shore University Hospital, Manhasset, NY 11030.
Insights
This study found all infants and children with cerebral blindness had abnormal visual evoked potentials (VEPs). Recommendations include using both flash and pattern stimuli for comprehensive visual assessments.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- Cerebral blindness in infants and children presents diagnostic challenges.
- Visual evoked potentials (VEPs) are crucial for assessing visual pathway function.
Purpose of the Study:
- To evaluate VEP abnormalities in children with cerebral blindness.
- To compare VEP findings with age-matched normative data.
- To refine VEP testing protocols for this population.
Main Methods:
- Recorded flash and pattern VEPs in 60 infants and children (6 weeks to 10 years) with cerebral blindness.
- Compared patient VEPs against age-matched normative data.
- Analyzed VEP abnormalities across different stimuli and recording areas.
Main Results:
- All 60 patients exhibited abnormal VEPs.
- 18 patients had absent flash and pattern VEPs; 13 had atypical VEPs.
- Most remaining patients showed greater pattern than flash VEP abnormalities, particularly in parietal and temporal regions.
Conclusions:
- VEPs are consistently abnormal in pediatric cerebral blindness.
- Comprehensive VEP assessment requires both flash and pattern stimuli.
- Recording beyond occipital areas and using age-specific norms are recommended for accurate diagnosis.
Abstract:
Visual evoked potentials (VEPs) were recorded of 60 infants and children with cerebral blindness, aged between six weeks and 10 years, and compared with age-matched normative data. Every patient had abnormal VEPs. 18 had absent flash and pattern VEPs and 13 had atypical or atypical and asymmetrical flash and pattern VEPs. Of the remaining 29, most had greater abnormality of pattern than of flash VEPs and greater abnormalities over parietal and temporal than occipital areas. Eight patients had normal occipital responses to flash and five others had delayed responses with normal morphology. One had normal occipital responses to pattern stimuli. All of these had abnormal late occipital responses or abnormal responses over the parietal and temporal areas. It is recommended that visual assessments using VEPs employ both flash and pattern stimuli, that pre-occipital as well as occipital recordings be made and that tracings be compared with age-specific normative data.