title: Visual function in infants with West syndrome: correlation with EEG patterns.
abstract: OBJECTIVE
  Several studies have reported behavioral and electrophysiological evidence of visual impairment during the active stage of West syndrome. The underlying mechanisms are, however, poorly understood, and little has been reported about the correlation between visual impairment, EEG patterns, and brain lesions. The aim of the study was to assess visual function at the onset of spasm and 2 months thereafter and relate visual findings to brain lesions and EEG features.
  
  
  METHODS
  Twenty-five infants with West syndrome were enrolled and studied with (a) a full clinical assessment including a battery of tests specifically designed to assess visual function, (b) a video-polygraphic study, and (c) brain magnetic resonance imaging (MRI). Besides brain neuroimaging and EEG comparison with visual function, an intra-EEG analysis was performed to investigate the possible relation of EEG patterns to fluctuating visual behavior (fixation and following).
  
  
  RESULTS
  Twenty-two children had at least one abnormal result on one or more of the tests assessing visual function at T0. Visual impairment at the spasm onset was related to the sleep disorganization rather than to the hypsarrhythmic pattern in awake EEG. After 2 months, both EEG features become significantly linked to visual function. Visual function improved in several cases after 2 months, in parallel with the seizure regression. No relation was found between EEG patterns and fluctuating visual behavior.
  
  
  CONCLUSIONS
  The study supplies new evidence of the involvement of visual function in West syndrome. The presence of abnormal visual findings in infants without lesions on brain MRI suggests that visual abnormalities are due not only to brain injury but also to epileptic disorder per se. New insight is also provided into the possible mechanisms underlying clinical and EEG abnormalities.
authors.affiliation: Division of Child Neurology and Psychiatry, Catholic University, Rome, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Randò
authors.forename: Adina
authors.initials: A
authors.lastname: Bancale
authors.forename: Giovanni
authors.initials: G
authors.lastname: Baranello
authors.forename: Margherita
authors.initials: M
authors.lastname: Bini
authors.forename: Anton Giulio
authors.initials: AG
authors.lastname: De Belvis
authors.forename: Roberta
authors.initials: R
authors.lastname: Epifanio
authors.forename: Maria Flavia
authors.initials: MF
authors.lastname: Frisone
authors.forename: Andrea
authors.initials: A
authors.lastname: Guzzetta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Torre
authors.forename: Daniela
authors.initials: D
authors.lastname: Ricci
authors.forename: Sabrina
authors.initials: S
authors.lastname: Signorini
authors.forename: Francesca
authors.initials: F
authors.lastname: Tinelli
authors.forename: Enrico
authors.initials: E
authors.lastname: Biagioni
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Veggiotti
authors.forename: Eugenio
authors.initials: E
authors.lastname: Mercuri
authors.forename: Elisa
authors.initials: E
authors.lastname: Fazzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioni
authors.forename: Francesco
authors.initials: F
authors.lastname: Guzzetta
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001927:Brain Diseases / Q000175:diagnosis* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D004569:Electroencephalography / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D012890:Sleep / Q000502:physiology; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000503:physiopathology; D014741:Video Recording; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D014787:Vision Tests