Visually evoked potentials in 52 children requiring operative repair of craniosynostosis
K Mursch1, K Brockmann, J K Lang
1Department of Neurosurgery, Georg August University, Göttingen, Germany.
Insights
Pathological visually evoked potentials (VEP) may indicate early neuronal damage in infants with craniosynostosis. This non-invasive test can detect issues before physical signs of increased intracranial pressure appear.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neurosurgery
Background:
- Craniosynostosis is a condition where skull sutures fuse prematurely.
- Elevated intracranial pressure (ICP) is a potential complication.
- Early detection of neurological compromise is crucial for timely intervention.
Purpose of the Study:
- To determine the prevalence of abnormal visually evoked potentials (VEP) in children with craniosynostosis.
- To assess if VEP can detect neuronal damage before overt signs of elevated ICP.
Main Methods:
- Preoperative VEP analysis in 52 infants and young children with craniosynostosis.
- Evaluation of VEP latency and amplitude.
- Correlation of VEP findings with clinical signs and postoperative outcomes.
Main Results:
- 13 out of 52 children (25%) exhibited pathological VEP.
- Abnormalities were bilateral in all affected children.
- Pathological VEP findings, primarily prolonged latency, improved postoperatively.
Conclusions:
- Visually evoked potentials (VEP) may serve as an early, sensitive indicator of neuronal damage in craniosynostosis.
- VEP can detect subclinical neurological impairment before papilledema or other signs of elevated ICP.
- VEP monitoring could aid in managing craniosynostosis and preventing long-term neurological sequelae.
Abstract:
We evaluated the prevalence of pathological visually evoked potentials (VEP) before the appearance of papilledema or other signs of elevated intracranial pressure in children suffering from craniosynostosis. In 52 children (19 girls, 33 boys, median age 7.6 months, mean age 7.6 months, range from 3 to 34 months) preoperative VEP were analyzed. In 13 patients, pathological VEP were observed. In all children, both eyes were involved. Only 1 child suffered from papillar anomalies. Latency was pathological in 12 children, whereas the amplitude was suppressed in only 2 children. In all children with preoperative pathological VEP, postoperative controls (n = 4) were improved or normal. Thus, VEP may be the first test for neuronal damage in craniosynostosis.
