title: Sweep visually evoked potentials and visual findings in children with West syndrome.
abstract: BACKGROUND
  West syndrome (WS) is a type of early childhood epilepsy characterized by progressive neurological development deterioration that includes vision.
  
  
  OBJECTIVE
  To demonstrate the clinical importance of grating visual acuity thresholds (GVA) measurement by sweep visually evoked potentials technique (sweep-VEP) as a reliable tool for evaluation of the visual cortex status in WS children.
  
  
  METHODS
  This is a retrospective study of the best-corrected binocular GVA and ophthalmological features of WS children referred for the Laboratory of Clinical Electrophysiology of Vision of UNIFESP from 1998 to 2012 (Committee on Ethics in Research of UNIFESP n° 0349/08). The GVA deficit was calculated by subtracting binocular GVA score (logMAR units) of each patient from the median values of age norms from our own lab and classified as mild (0.1-0.39 logMAR), moderate (0.40-0.80 logMAR) or severe (>0.81 logMAR). Associated ophthalmological features were also described.
  
  
  RESULTS
  Data from 30 WS children (age from 6 to 108 months, median = 14.5 months, mean ± SD = 22.0 ± 22.1 months; 19 male) were analyzed. The majority presented severe GVA deficit (0.15-1.44 logMAR; mean ± SD = 0.82 ± 0.32 logMAR; median = 0.82 logMAR), poor visual behavior, high prevalence of strabismus and great variability in ocular positioning. The GVA deficit did not vary according to gender (P = .8022), WS type (P = .908), birth age (P = .2881), perinatal oxygenation (P = .7692), visual behavior (P = .8789), ocular motility (P = .1821), nystagmus (P = .2868), risk of drug-induced retinopathy (P = .4632) and participation in early visual stimulation therapy (P = .9010).
  
  
  CONCLUSIONS
  The sweep-VEP technique is a reliable tool to classify visual system impairment in WS children, in agreement with the poor visual behavior exhibited by them.
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Patrícia
authors: P
authors: de Freitas Dotto
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Nívea Nunes
authors: NN
authors: Cavascan
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Adriana
authors: A
authors: Berezovsky
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Paula Yuri
authors: PY
authors: Sacai
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Daniel Martins
authors: DM
authors: Rocha
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.
authors: Josenilson Martins
authors: JM
authors: Pereira
authors: Departamento de Oftalmologia, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil. Electronic address: ssalomao@unifesp.br.
authors: Solange Rios
authors: SR
authors: Salomão
mesh_terms: D002648:Child; D002675:Child, Preschool; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000503:physiopathology*; D014793:Visual Cortex / Q000503:physiopathology*
keywords: Childhood epilepsy; Cortical visual impairment; Grating visual acuity; Nystagmus; Strabismus; Sweep visual evoked potentials; West syndrome