The Application of Multifocal Visual Evoked Potentials in Cerebral Palsy Children_West China Medical Journal

Authors：

 TangAngcang ¹ , LuoRong ² , DongXiaoli ³ ,  LiuLongqian ¹

1. Department of Ophthalmology, West China Hospital, Chengdu, Sichuan 610041, P. R. China;
2. Neurological Rehabilitation Department for Children, West China Second University Hospital;Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Children Rehabilitation, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LiuLongqian, Email: bq15651@hotmail.com

Keywords：

Cerebral Palsy; Multifocal visual evoked potentials; Gross Motor Function Classification System

DOI：

10.7507/1002-0179.201600289

Video：

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Objective To evaluate the differences of visual evoked potentials (amplitudes and latency) between cerebral palsy (CP) children and normal children. Methods This study involved fourteen children aged from 4 to 7 years with CP (monoplegia) between 2009 and 2013. Another 14 normal children aged from 5 to 9 years treated in the Department of Ophthalmology in West China Hospital during the same period were regarded as the control group. Both eyes of all the participants were examined by multifocal visual evoked potential (mfVEP). The mfVEP examination results were recorded, and amplitude and latency were analyzed. First, we analyzed the differences of amplitudes and latency time between monoplegia children and children in the control group. Second, gross motor function classification system (GMFCS) was used to classify the fourteen monoplegia children among whom there were five GMFCS Ⅰ patients and nine GMFCS Ⅱ patients. The differences of mfVEP were analyzed between the two GMFCS groups. Results The amplitude and latency of mfVEP in children with CP showed gradual changes similar to those in the normal children. The amplitudes were decreasing and the latencies were delaying from the first eccentricity to the sixth eccentricity. The amplitudes in children with CP were lower than those in the control group in the first to the third eccentricities for both eyes (P＜0.05), and latency of left eye was delayed in the first eccentricity in children with CP (P=0.045). No difference was found between the two GMFCS groups (P>0.05) except the amplitude of the first eccentricity (P=0.043). Conclusions The results of mfVEP show significant differences of amplitude and latency between CP and normal children, suggesting the existence of visual pathway impairments in cerebral palsy children. The results of mfVEP can provide an objective basis of visual impairments for cerebral palsy children.

Citation： TangAngcang, LuoRong, DongXiaoli, LiuLongqian. The Application of Multifocal Visual Evoked Potentials in Cerebral Palsy Children. West China Medical Journal, 2016, 31(6): 1074-1079. doi: 10.7507/1002-0179.201600289 Copy

1.	肖侠明. 小儿神经疾病诊断与治疗[M]. 北京: 人民卫生出版社, 2008: 375-382.
2.	Oskoui M, Coutinho F, Dykeman J, et al. An update on the prevalence of cerebral palsy: a systematic review and metaanalysis[ J]. Dev Med Child Neurol, 2013, 55(6): 509-519.
3.	Bialik GM, Givon U. Cerebral palsy: classification and etiology[J]. Acta Orthop Traumatol Turc, 2009, 43(2): 77-80.
4.	Jan MM. Cerebral palsy: comprehensive review and update[J]. Ann Saudi Med, 2006, 26(2): 123-132.
5.	Reddihough DS, Collins KJ. The epidemiology and causes of cerebral palsy[J]. Aust J Physiother, 2003, 49(1): 7-12.
6.	Black P. Visual disorders associated with cerebral palsy[J]. Br J Ophthalmol, 1982, 66(1): 46-52.
7.	Dutton GN, Calvert J, Cockburn D, et al. Visual disorders in children with cerebral palsy: the implications for rehabilitation programs and school work[J]. East J Med, 2012, 17(4): 178-187.
8.	文香淑. 脑性瘫痪儿童的视觉障碍[J]. 中国康复医学杂志, 2005, 20(6): 477-478.
9.	Ghasia F, Brunstrom J, Gordon M, et al. Frequency and severity of visual sensory and motor deficits in children with cerebral palsy: gross motor function classification scale[J]. Invest Ophthalmol Vis Sci, 2008, 49(2): 572-580.
10.	Hu XP, Huang SZ, Wu LZ. Multifocal VEP in patients with optic nerve disease[J]. Int J Ophthalmol, 2007, 7(4): 925-928.
11.	Vargiami E, Di ZO, Kozeis N, et al. Flash VEP findings in children with bilateral spastic cerebral palsy: correlation with clinicoradiological parameters[J]. J Pediatr Neurol, 2008, 46(4): 329-339.
12.	Farah Nabil Abbas Al-Sadik. Visual evoked potential in children with spastic cerebral palsy[J]. Med J Babylon, 2012, 9(2): 379-384.
13.	中国康复医学会儿童康复专业委员会. 小儿脑性瘫痪的定义、分型和诊断条件[J]. 中华物理医学与康复杂志, 2007, 29(5): 309.
14.	Palisano R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy[J]. Dev Med Child Neurol, 1997, 39(4): 214-223.
15.	Morris C, Bartlett D. Gross motor function classification system: impact and utility[J]. Dev Med Child Neurol, 2004, 46(1): 60-65.
16.	Arnoldi KA, Pendarvis L, Jackson J, et al. Cerebral palsy for the pediatric eye care team PartⅢ: Diagnosis and Management of Associated Visual and Sensory Disorders[J]. Am Orthopt J, 2006, 56: 97-107.
17.	Katoch S, Devi A, Kulkarni P. Ocular defects in cerebral palsy[J]. Indian J Ophthalmol, 2007, 5(2):154-156.
18.	侯梅, 孙殿荣, 单若冰, 等. 脑瘫共患病及其与脑瘫类型和粗大运动功能分级的关系[J]. 中华儿科杂志, 2010, 48(5): 351-354.
19.	Scheiman MM. Optometric findings in children with cerebral palsy[J]. Am J Optom Physiol Opt, 1984, 61(5): 321-323.
20.	Erkkilä H, Lindberg L, Kallio AK. Strabismus in children with cerebral palsy[J]. Acta Ophthalmol Scand, 1996, 74(6): 636-638.
21.	Pennefather PM, Tin W. Ocular abnormalities associated with cerebral palsy after preterm birth[J]. Eye (Lond), 2000, 14(Pt 1): 78-81.
22.	Guzzetta A, Mercuri E, Cioni G. Visual disorders in children with brain lesions: 2. Visual impairment associated with cerebral palsy[J]. Eur J Paediatr Neurol, 2001, 5(3): 115-119.
23.	Humphreys P, Whiting S, Pham B. Hemiparetic cerebral palsy: clinical pattern and imaging in prediction of outcome[J]. Can J Neurol Sci, 2000, 27(3): 210-219.
24.	Yukawa E, Matsuura T, Kim YJ, et al. Objective visual field evaluation using multifocal visual evoked potentials in patients with intracranial disease complicated by mental disorders[J]. Clin Neurol Neurosurg, 2008, 110(6): 592-598.
25.	Klistorner AI, Graham SL, Grigg JR, et al. Multifocal topographic visual evoked potential: improving objective detection of local visual field defects[J]. Invest Ophthalmol Vis Sci, 1998, 39(6): 937-950.
26.	Hoffmann MB, Lorenz B, Preising M, et al. Assessment of cortical visual field representations with multifocal VEPs in control subjects, patients with albinism, and female carriers of ocular albinism[J]. Invest Ophthalmol Vis Sci, 2006, 47(7): 3195-3201.
27.	Balachandran C, Klistorner AI, Billson F. Multifocal VEP in children: its maturation and clinical application[J]. Br J Ophthalmol, 2004, 88(2): 226-232.
28.	Seiple W, Holopigian K, Clemens C, et al. The multifocal visual evoked potential: an objective measure of visual fields?[J]. Vision Res, 2005, 45(9): 1155-1163.
29.	Baseler HA, Sutter EE. M and P components of the VEP and their visual field distribution[J]. Vision Res, 1997, 37(6): 675-690.
30.	李海生, 潘家普. 视觉电生理的原理与实践[M]. 上海: 上海科学普及出版社, 2002: 190-223.
31.	Klistorner A, Crewther DP, Crewther SG. Separate magnocellular and parvocellular contributions from temporal analysis of the multifocal VEP[J]. Vision Res, 1997, 37(15): 2161-2169.
32.	Atilla H, Tekeli O, Ornek K, et al. Pattern electroretinography and visual evoked potentials in optic nerve diseases[J]. J Clin Neurosci, 2006, 13(1): 55-59.
33.	Accornero N, Gregori B, Pro S, et al. Chromatic modulation of luminance visual evoked potential latencies in healthy subjects and patients with mild vision disorders[J]. Clin Neurophysiol, 2008, 119(7): 1683-1688.

1. 肖侠明. 小儿神经疾病诊断与治疗[M]. 北京: 人民卫生出版社, 2008: 375-382.
2. Oskoui M, Coutinho F, Dykeman J, et al. An update on the prevalence of cerebral palsy: a systematic review and metaanalysis[ J]. Dev Med Child Neurol, 2013, 55(6): 509-519.
3. Bialik GM, Givon U. Cerebral palsy: classification and etiology[J]. Acta Orthop Traumatol Turc, 2009, 43(2): 77-80.
4. Jan MM. Cerebral palsy: comprehensive review and update[J]. Ann Saudi Med, 2006, 26(2): 123-132.
5. Reddihough DS, Collins KJ. The epidemiology and causes of cerebral palsy[J]. Aust J Physiother, 2003, 49(1): 7-12.
6. Black P. Visual disorders associated with cerebral palsy[J]. Br J Ophthalmol, 1982, 66(1): 46-52.
7. Dutton GN, Calvert J, Cockburn D, et al. Visual disorders in children with cerebral palsy: the implications for rehabilitation programs and school work[J]. East J Med, 2012, 17(4): 178-187.
8. 文香淑. 脑性瘫痪儿童的视觉障碍[J]. 中国康复医学杂志, 2005, 20(6): 477-478.
9. Ghasia F, Brunstrom J, Gordon M, et al. Frequency and severity of visual sensory and motor deficits in children with cerebral palsy: gross motor function classification scale[J]. Invest Ophthalmol Vis Sci, 2008, 49(2): 572-580.
10. Hu XP, Huang SZ, Wu LZ. Multifocal VEP in patients with optic nerve disease[J]. Int J Ophthalmol, 2007, 7(4): 925-928.
11. Vargiami E, Di ZO, Kozeis N, et al. Flash VEP findings in children with bilateral spastic cerebral palsy: correlation with clinicoradiological parameters[J]. J Pediatr Neurol, 2008, 46(4): 329-339.
12. Farah Nabil Abbas Al-Sadik. Visual evoked potential in children with spastic cerebral palsy[J]. Med J Babylon, 2012, 9(2): 379-384.
13. 中国康复医学会儿童康复专业委员会. 小儿脑性瘫痪的定义、分型和诊断条件[J]. 中华物理医学与康复杂志, 2007, 29(5): 309.
14. Palisano R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy[J]. Dev Med Child Neurol, 1997, 39(4): 214-223.
15. Morris C, Bartlett D. Gross motor function classification system: impact and utility[J]. Dev Med Child Neurol, 2004, 46(1): 60-65.
16. Arnoldi KA, Pendarvis L, Jackson J, et al. Cerebral palsy for the pediatric eye care team PartⅢ: Diagnosis and Management of Associated Visual and Sensory Disorders[J]. Am Orthopt J, 2006, 56: 97-107.
17. Katoch S, Devi A, Kulkarni P. Ocular defects in cerebral palsy[J]. Indian J Ophthalmol, 2007, 5(2):154-156.
18. 侯梅, 孙殿荣, 单若冰, 等. 脑瘫共患病及其与脑瘫类型和粗大运动功能分级的关系[J]. 中华儿科杂志, 2010, 48(5): 351-354.
19. Scheiman MM. Optometric findings in children with cerebral palsy[J]. Am J Optom Physiol Opt, 1984, 61(5): 321-323.
20. Erkkilä H, Lindberg L, Kallio AK. Strabismus in children with cerebral palsy[J]. Acta Ophthalmol Scand, 1996, 74(6): 636-638.
21. Pennefather PM, Tin W. Ocular abnormalities associated with cerebral palsy after preterm birth[J]. Eye (Lond), 2000, 14(Pt 1): 78-81.
22. Guzzetta A, Mercuri E, Cioni G. Visual disorders in children with brain lesions: 2. Visual impairment associated with cerebral palsy[J]. Eur J Paediatr Neurol, 2001, 5(3): 115-119.
23. Humphreys P, Whiting S, Pham B. Hemiparetic cerebral palsy: clinical pattern and imaging in prediction of outcome[J]. Can J Neurol Sci, 2000, 27(3): 210-219.
24. Yukawa E, Matsuura T, Kim YJ, et al. Objective visual field evaluation using multifocal visual evoked potentials in patients with intracranial disease complicated by mental disorders[J]. Clin Neurol Neurosurg, 2008, 110(6): 592-598.
25. Klistorner AI, Graham SL, Grigg JR, et al. Multifocal topographic visual evoked potential: improving objective detection of local visual field defects[J]. Invest Ophthalmol Vis Sci, 1998, 39(6): 937-950.
26. Hoffmann MB, Lorenz B, Preising M, et al. Assessment of cortical visual field representations with multifocal VEPs in control subjects, patients with albinism, and female carriers of ocular albinism[J]. Invest Ophthalmol Vis Sci, 2006, 47(7): 3195-3201.
27. Balachandran C, Klistorner AI, Billson F. Multifocal VEP in children: its maturation and clinical application[J]. Br J Ophthalmol, 2004, 88(2): 226-232.
28. Seiple W, Holopigian K, Clemens C, et al. The multifocal visual evoked potential: an objective measure of visual fields?[J]. Vision Res, 2005, 45(9): 1155-1163.
29. Baseler HA, Sutter EE. M and P components of the VEP and their visual field distribution[J]. Vision Res, 1997, 37(6): 675-690.
30. 李海生, 潘家普. 视觉电生理的原理与实践[M]. 上海: 上海科学普及出版社, 2002: 190-223.
31. Klistorner A, Crewther DP, Crewther SG. Separate magnocellular and parvocellular contributions from temporal analysis of the multifocal VEP[J]. Vision Res, 1997, 37(15): 2161-2169.
32. Atilla H, Tekeli O, Ornek K, et al. Pattern electroretinography and visual evoked potentials in optic nerve diseases[J]. J Clin Neurosci, 2006, 13(1): 55-59.
33. Accornero N, Gregori B, Pro S, et al. Chromatic modulation of luminance visual evoked potential latencies in healthy subjects and patients with mild vision disorders[J]. Clin Neurophysiol, 2008, 119(7): 1683-1688.

West China Medical Journal

The Application of Multifocal Visual Evoked Potentials in Cerebral Palsy Children

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