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Evaluation of central nervous conduction by visual evoked potentials in insulin-dependent diabetic children.
Insights
Diabetic children with central nervous system (CNS) damage showed delayed visual evoked potentials (VEPs). These central nervous system changes appear to progress alongside peripheral neuropathy in type 1 diabetes.
Area of Science:
- Neuroscience
- Endocrinology
- Ophthalmology
Background:
- Diabetic peripheral neuropathy is common, but central nervous system (CNS) involvement is less understood.
- Visual evoked potentials (VEPs) offer a non-invasive method to assess CNS function.
Purpose of the Study:
- To investigate central nervous system (CNS) alterations in children with type 1 diabetes using VEPs.
- To explore the relationship between VEPs, diabetes duration, glycemic control, and peripheral neuropathy.
Main Methods:
- Evaluated 71 children with type 1 diabetes and 33 controls using pattern reversal VEPs.
- Measured P100 wave latencies with checkerboard stimuli on a television display.
- Assessed peripheral nerve conduction velocity.
Main Results:
- Twenty-seven percent of diabetic children exhibited significantly prolonged P100 latencies, indicating CNS conduction delay.
- No correlation was found between VEP abnormalities and age, diabetes duration, insulin dose, or HbA1c levels.
- A negative correlation between VEP latencies and peripheral nerve conduction velocity was observed.
Conclusions:
- VEP testing is a simple, reliable method for detecting early CNS dysfunction in diabetic children.
- Central and peripheral nervous system alterations in diabetes appear to develop concurrently.
Abstract:
Peripheral neuropathy is a well-known complication of diabetes, but few data are available on central lesions. Visual evoked potentials (VEPs) seem a reliable and feasible technique for detecting a conduction delay in the central nervous system. Seventy-one insulin-dependent type 1 diabetic children (mean age 15 +/- 3 years) and 33 controls were investigated for central neuropathy. We used a pattern of reversal stimulation with television display of a checker board pattern (15 min and 30 min check size). The latencies of the positive peak (P100 wave) were significantly lengthened in 17 patients (27%) but no correlation was found between VEPs and age, duration of diabetes, insulin requirement and HbA1 level. A negative correlation was found between VEPs and peripheral nervous conduction velocity. VEPs measurement seems a simple and reliable technique for detecting early alterations in CNS function in diabetics. Our data suggest that central and peripheral nervous alterations progress simultaneously.