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Are VEP abnormalities in optic neuritis (ON) dependent on plaque size? A reappraisal of the physiopathology of ON based on improved MRI and multiple-lead recordings

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Abstract

Twenty patients with optic neuritis (ON) described in the previous study [23] underwent serial VEP recordings (using multiple electrode arrays) for two years. The VEPs could be correlated with the lesions revealed by MRI, Visual Field tests and other clinical findings. On the basis of their scalp distribution, they were classified as “really delayed” VEPs and “pseudo-delayed” VEPs.

Real delays could be recorded at the onset of ON or shortly afterwards, and their appearance indicated the recovery of visual function and a good prognosis.

Pseudo-delays indicated an alteration in the visual field and, unless a breakthrough of normal or delayed components appeared in the first three months, following acute ON, indicate a poor prognosis for the recovery of visual function.

The pseudo-delayed VEPs were mainly observed in patients with longer lesions revealed by means of LTE-STIR MRI [23]; there was no correlation between VEP latency and the length of plaques.

Our findings contradict previous theories on the timing of conduction alterations in ON and multiple sclerosis.

Sommario

I 20 pazienti affetti da Neurite Ottica (NO), descritti nel precedente lavoro [23] sono stati sottoposti a registrazioni seriali multicanali dei Potenziali Evocati Visivi (PEV), per un periodo di 2 anni dall'esordio della NO. I PEV potevano correlare con le lesioni evidenziate con la Risonanza Magnetica, con le alterazioni campimetriche e con altri reperti clinici. Basandoci sulla loro distribuzione in mappa, i PEV sono stati classificati come realmente “ritardati” e “pseudo-ritardati”. PEV realmente “ritardati” potevano essere registrati all'esordio, o precocemente dopo l'episodio di NO, e la presenza del “ritardo” stava ad indicare un recupero della funzione visiva e, quindi, una prognosi fausta.

Gli “pseudo-ritardi” indicavano un'alterazione del campo visivo a prognosi non favorevole per un recupero della funzione visiva, a meno che entro i primi 3 mesi dalla NO si fosse verificata una ricomparsa di componenti normali o “ritardate”.

Gli “pseudo-ritardi” erano rilievi caratteristici nei pazienti con lesioni maggiormente lunghe alle immagini LTE-STIR MRI [23]. Nessuna correlazione è stata trovata tra latenza dei PEV e lunghezza delle placche.

I nostri rilievi sono in disaccordo con precedenti teorie relative ai tempi di instaurazione-recupero delle alterazioni di conduzione nella NO e nella Sclerosi Multipla.

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Authors and Affiliations

  1. Istituto di Clinica Neurologica e Scienze del Comportamento, Università degli Studi “G. D'Annunzio”, Chieti, Italy

    Fulgente T., Thomas A., Gambi D. & Onofrj M.

  2. Istituto di Clinica Oculistica, Università degli Studi “G. D'Annunzio”, Chieti, Italy

    Lobefalo L., Mastropasqua L. & Gallenga P. E.

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  1. Fulgente T.
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  2. Thomas A.
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  3. Lobefalo L.
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  4. Mastropasqua L.
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  5. Gallenga P. E.
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  6. Gambi D.
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  7. Onofrj M.
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Fulgente, T., Thomas, A., Lobefalo, L. et al. Are VEP abnormalities in optic neuritis (ON) dependent on plaque size? A reappraisal of the physiopathology of ON based on improved MRI and multiple-lead recordings. Ital J Neuro Sci 17, 43–54 (1996). https://doi.org/10.1007/BF01995708

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  • DOI: https://doi.org/10.1007/BF01995708

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