Intraoperative visual evoked potential monitoring for optic pathway glioma in an infant: A case description

Liming Qiu, Santhi Chigurupathi, Wan Tew SEOW, Sharon YY LOW

    Research output: Contribution to journalLetterpeer-review


    Intraoperative neuro physiological monitoring (IONM) aims to preserve neurological function and minimize postoperative deficit.Utility of techniques such as motor-evoked potentials, somatosensory-evoked potentials and brainstem auditory evoked potential sare well-established neurosurgical adjuncts involving eloquent brain regions, especially in adult neuro oncology (Sanai and Berger,2010). Visual-evoked potential (VEP) is a simple, non-invasive method of assessing the functional integrity of visual pathway from the retina to the visual cortex. Previously, it was reported to have poor reproducibility and result variability (Cedzich et al., 1988).Advancements in anesthesia as well as high luminance devices such as light-emitting diodes (LEDs) have led to the re-emergence of interest in intraoperative flash VEP monitoring. A significant change in recent decades was the move towards total intravenous anesthesia (TIVA) as the anesthesia of choice whenever IONM is required, as inhalational agents have been repeatedly shown to affect all evoked potentials. Under such circumstances, it has been proposed that VEPs may be helpful for infants and young children who are pre-linguistic or unable to communicate visual symptoms (Taylor and McCulloch, 1992). However, the issue of neuronal immaturity in thisage group is a challenge to accurate IONM findings (Coppola et al.,2016). At the time of this writing, there are no large-scale studies focusing on the use of intraoperative VEPs for pediatric brain tumors involving the optic pathway. We describe the customized application of intraoperative VEPs for a toddler diagnosed with a tumor involving the anterior visual pathway.
    Original languageEnglish
    Pages (from-to)1772-1774
    Number of pages3
    JournalClinical Neurophysiology
    Issue number8
    Early online date19 May 2020
    Publication statusPublished - Aug 2020


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