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Updated: Apr 20, 2026
Stimulus-specific Cortical Visual Evoked Potential Morphological Patterns
Published on: May 12, 2019
Visual evoked potentials in a diagnosis of a visual pathway dysfunction of a child with an arachnoid cyst
Joanna Karaśkiewicz1, Wojciech Lubiński, Krzysztof Penkala
1Department of Ophthalmology, Pomeranian Medical University, Ul. Powstańców Wielkopolskich 72, 70- 111, Szczecin, Poland, karaskiewicz.joanna@gmail.com.
Insights
Flash visual evoked potentials (VEPs) can monitor intracranial hypertension in children with arachnoid cysts. Deteriorating VEPs indicated worsening pressure, guiding timely neurosurgical intervention.
Area of Science:
- Neuroscience
- Ophthalmology
- Pediatric Neurology
Background:
- Congenital arachnoid cysts can lead to increased intracranial pressure.
- Monitoring neurological status in preterm infants with congenital anomalies is crucial.
Observation:
- A preterm infant with a congenital arachnoid cyst presented with ocular abnormalities including exotropia and poor fixation.
- Initial flash visual evoked potentials (VEPs) were normal, but deteriorated over one year, showing increased N2 and P2 peak times.
- These VEP changes were the sole ocular indicators of worsening intracranial hypertension.
Findings:
- Flash visual evoked potentials (VEPs) demonstrated a decline in signal quality and increased latencies over time.
- The observed VEP abnormalities correlated with the development of intracranial hypertension.
- Neurosurgical intervention via shunt placement was performed following the identification of elevated intracranial pressure.
Implications:
- Flash visual evoked potentials (VEPs) serve as a valuable, non-invasive tool for monitoring intracranial hypertension in pediatric patients.
- VEP monitoring can aid in the early detection of neurological deterioration in children with arachnoid cysts.
- This case highlights the utility of VEPs in managing complex pediatric neurological conditions.
Purpose:
The aim of this case report was to demonstrate the usefulness of the flash visual evoked potentials in monitoring the effects of intracranial hypertension in a preterm-born child with a congenital arachnoid cyst.
Methods And Results:
At baseline, abnormalities were found in the right eye: exotropia and lack of foveal fixation. Visual acuity was not achieved. Pupillary responses were normal in both eyes. There was no evidence of nystagmus. Flash visual evoked potentials were normal and equal in both eyes. When repeated one year later the signal had deteriorated in both eyes; the peak times of N2 and P2 had increased. The increased VEP latencies were the only ocular signs noted. After referral to neurosurgery, intracranial hypertension was found and a shunt was performed.
Conclusions:
Flash visual evoked potentials may be a valuable test in monitoring patients with arachnoid cysts.
