Visual evoked potentials in a diagnosis of a visual pathway dysfunction of a child with an arachnoid cyst

Abstract

PurposeThe 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 resultsAt 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.ConclusionsFlash visual evoked potentials may be a valuable test in monitoring patients with arachnoid cysts.

Multichannel visual evoked potentials in the assessment of visual pathways in children with marked brain abnormalities

“…All the 4 cases presented were being monitored by neurosurgical teams for raised inter cranial pressure (ICP). Changes in ICP have a well-documented affect on VEP amplitude and latency [15][16][17] . Therefore in these children where responses were present, the responses not only gives a quantitative measure of visual function but also provides a baseline for monitoring the effects of changes in ICP.…”

Ophthalmological symptoms in children with intracranial cysts

“…The importance of the VEP test in the diagnosis of visual pathway dysfunctions has been emphasised by some authors 4 , 8 , 11 . VEPs are visually evoked electrophysiological signals recorded over the visual cortex.…”

“…However, in the analysed groups, the authors do not mention conducting an ophthalmological assessment. Meanwhile, in the literature, one can find numerous descriptions of individual cases in which arachnoid cysts were accompanied by visual disorders 4 – 11 .…”