Electroencephalograms of children with permanent cortical visual impairment

The electroencephalograms of 40 children with permanent cortical visual impairment (CVI) were studied. CVI was diagnosed in the presence of severe visual loss, normal or minimal ocular findings and clinical, electrodiagnostic and CT evidence of postgeniculate lesions involving the visual cortex. All patients had a multidisciplinary evaluation, including extensive neurological and ophthalmological investigations. The records did not contain any specific features which would be diagnostic of CVI. Isolated occipital spikes were rare and more commonly multifocal EEG disturbance was seen because of diffuse cerebral involvement. Photic stimulation was of little use in the diagnosis. Multihandicapped children with profound CVI tended to show multifocal abnormalities, no alpha rhythm and a suppressed posterior waking background in their EEGs, whereas those with more residual vision usually had an alpha rhythm. The presence or absence of alpha rhythm seemed to reflect the intactness of the striate cortex. However, the lack of alpha rhythm was not always associated with total blindness and not all children with useful residual vision had alpha rhythm.