Visual function in infants with West syndrome: Correlation with EEG patterns

Teresa Randò, Adina Bancale, Giovanni Baranello, Margherita Bini, Anton Giulio De Belvis, Roberta Epifanio, Maria Flavia Frisone, Andrea Guzzetta, Giuseppe La Torre, Daniela Ricci, Sabrina Signorini, Francesca Tinelli, Enrico Biagioni, Pierangelo Veggiotti, Eugenio Mercuri, Elisa Fazzi, Giovanni Cioni, Francesco Guzzetta

Research output: Contribution to journalArticle

Abstract

Purpose: 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 T 0. 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.

Original languageEnglish
Pages (from-to)781-786
Number of pages6
JournalEpilepsia
Volume45
Issue number7
DOIs
Publication statusPublished - Jul 2004

Keywords

  • Brain lesions
  • Visual function
  • West syndrome

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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    Randò, T., Bancale, A., Baranello, G., Bini, M., De Belvis, A. G., Epifanio, R., Frisone, M. F., Guzzetta, A., La Torre, G., Ricci, D., Signorini, S., Tinelli, F., Biagioni, E., Veggiotti, P., Mercuri, E., Fazzi, E., Cioni, G., & Guzzetta, F. (2004). Visual function in infants with West syndrome: Correlation with EEG patterns. Epilepsia, 45(7), 781-786. https://doi.org/10.1111/j.0013-9580.2004.41403.x