Prevalence of abnormal pattern reversal visual evoked potentials in craniosynostosis
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Stimulus-specific Cortical Visual Evoked Potential Morphological Patterns
Published on: May 12, 2019
Dorothy A Thompson1, Alki Liasis, Sharon Hardy
1Tony Kriss Visual Electrophysiology Unit and the Department of Ophthalmology, Great Ormond Street Hospital for Children, Great Ormond Street Hospital, London WC1N 3JH, United Kingdom.
Insights
A majority of children with craniosynostosis exhibit abnormal pattern reversal visual evoked potentials (VEPs) at their initial assessment. Early electrophysiologic evaluation is crucial for monitoring visual pathway function in these patients.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatrics
Background:
- Craniosynostosis is a condition involving premature fusion of skull sutures.
- Visual pathway dysfunction can occur in children with craniosynostosis.
Purpose of the Study:
- To determine the prevalence and types of abnormalities in pattern reversal visual evoked potentials (VEPs) in children with craniosynostosis.
- To establish baseline electrophysiologic visual pathway assessments for affected children.
Main Methods:
- Visual evoked potentials (VEPs) were recorded from 114 children with craniosynostosis (syndromic and nonsyndromic) before any surgical intervention.
- Pattern reversal VEPs were elicited using 50' checks and analyzed for amplitude, latency, and waveform characteristics.
Main Results:
- Sixty percent of patients demonstrated abnormal pattern reversal VEPs.
- Abnormalities were not significantly associated with patient age or craniosynostosis classification.
Conclusions:
- A high prevalence of abnormal VEPs suggests widespread visual pathway dysfunction in craniosynostosis patients.
- Baseline electrophysiologic assessment is essential for all children with craniosynostosis at their first presentation for future monitoring.
Background:
The purpose of this study was to examine the prevalence and type of changes observed in the pattern reversal visual evoked potentials recorded at the first assessment of children with craniosynostosis.
Methods:
Visual evoked potentials were recorded from 114 patients with craniosynostosis. Eighty-one patients were syndromic and 33 were nonsyndromic. No patient had received any craniofacial surgical intervention. At the time of the test, 22 of 40 patients were aged 6 months and younger, and 18 patients were between 6 months and 1 year of age. Pattern reversal visual evoked potentials were recorded from a midoccipital electrode positioned 3 cm above the inion. The pattern reversal visual evoked potentials elicited to 50' checks with three reversals per second viewed with both eyes were analyzed for n80-p100 amplitude, p100 latency, and breadth of waveform.
Results:
Sixty percent of patients had abnormal pattern reversal visual evoked potentials to 50' checks. This did not show a significant association with age, or classification of craniosynostosis.
Conclusions:
The high prevalence of abnormal pattern reversal visual evoked potentials to a robust stimulus suggests that visual pathway dysfunction, as measured electrophysiologically, can affect a majority of patients with craniosynostosis. This study indicates that a baseline evaluation of all children with craniosynostosis at their first presentation is essential if subsequent electrophysiologic visual pathway monitoring is to take place.
