Prognostic utility of visual evoked potentials in term asphyxiated neonates

The prognosis for term infants with birth asphyxia is variable and does not correlate well with the acute clinical state. Diagnostic tools such as electroencephalography or imaging techniques have not been satisfactory predictors of outcome. Visual evoked potentials (VEPs) have changed acutely in birth asphyxia and may provide information for long-term prognosis. We studied VEPs serially in 25 term infants with documented birth asphyxia. The VEPs were classified into three categories: normal, mildly abnormal, or severely abnormal, and then compared to each infant's acute clinical state and outcome at age six months. Eight of the nine infants with normal or mildly abnormal VEPs were normal when examined subsequently. All the patients with severely abnormal VEPs died, or suffered severe neurologic sequelae. The VEPs demonstrated good correlation with neurodevelopmental outcomes in infants with birth asphyxia and may be useful prognostically.