title: Flash visual evoked potentials are not specific enough to identify parieto-occipital lobe involvement in term neonates after significant hypoglycaemia.
abstract: OBJECTIVE
  Hypoglycaemia is a significant problem in high-risk neonates and predominant parieto-occipital lobe involvement has been observed after severe hypoglycaemic insult. We explored the use of flash visual evoked potentials (FVEP) in detecting parieto-occipital lobe involvement after significant hypoglycaemia.
  
  
  METHODS
  Full-term neonates (n = 15) who underwent FVEP from January 2008 to May 2013 were compared with infants (n = 11) without hypoglycaemia or parietal-occipital lobe injury. Significant hypoglycaemia was defined as being symptomatic or needing steroids, glucagon or a glucose infusion rate of ≥12 mg/kg/min.
  
  
  RESULTS
  The hypoglycaemia group exhibited delayed latency of the first positive waveform on FVEP. The initial detected time for hypoglycaemia was later in the eight subjects with seizures (median 51-h-old) than those without (median 22-h-old) (P = 0.003). Magnetic resonance imaging showed that 80% of the hypoglycaemia group exhibited occipital-lobe injuries, and they were more likely to exhibit abnormal FVEP morphology (P = 0.007) than the controls. FVEP exhibited 100% sensitivity, but only 25% specificity, for detecting injuries to the parieto-occipital lobes.
  
  
  CONCLUSIONS
  Flash visual evoked potential (FVEP) was sensitive, but not sufficiently specific, in identifying parieto-occipital lobe injuries among term neonates exposed to significant hypoglycaemia. Larger studies exploring the potential role of FVEP in neonatal hypoglycaemia are required.
authors.affiliation: Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Hu
authors.forename: Qiufang
authors.initials: Q
authors.lastname: Gu
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhu
authors.forename: Chenhao
authors.initials: C
authors.lastname: Yang
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
authors.forename: Yun
authors.initials: Y
authors.lastname: Cao
authors.forename: Wenhao
authors.initials: W
authors.lastname: Zhou
mesh_terms: D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D009778:Occipital Lobe / Q000503:physiopathology*; D010296:Parietal Lobe / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: Flash visual evoked potentials; Hypoglycaemia; Magnetic resonance imaging; Neonate; Parieto-occipital lobe injuries