Flash VEP findings in children with bilateral spastic cerebral palsy: Correlation with clinico-radiological parameters

The aim of the study was to investigate the relationship between abnormal visual evoked potential (VEP) findings and different clinico-radiological parameters in children with bilateral spastic cerebral palsy (CP). Seventy-two CP children (age range 18-96 months, mean age 36 months) was participated in this study. Data were collected retrospectively regarding patient's age, type of CP, pre-, peri- and postnatal events, and history of epilepsy. Evaluation of developmental quotient, and visual function, VEP, brainstem evoked potentials, electroencephalogram and magnetic resonance imaging (MRI) of the brain, were performed in all patients. Forty-three (59.7%) patients demonstrated abnormal VEP. Abnormal VEP were statistically correlated with motor deficit (spastic tetraplegia 86.4%; P =0 .006), abnormal electroencephalogram (62.7%; P< 0.001), abnormal MRI findings (periventricular leukomalacia alone 60.4%; P< 0.001 or with hypoxic-ischemic lesions 22.2%; P =0 .038, retrospectively), poor visual acuity (44%; P =0 .018) and low developmental quotient <40 (79%; P =0 .020). We conclude that abnormal VEP in children with bilateral spastic CP demonstrate a statistically significant correlation with the presence of spastic tetraplegia, epilepsy, periventricular leukomalacia with or without hypoxic-ischemic lesions in brain MRI, low visual acuity, and moderate to severe developmental delay. Since VEP constitute a non-invasive neurophysiological procedure, it should be incorporated in the diagnostic work-up of children with bilateral spastic CP.