Abnormalities of the pattern evoked potential in compression of the anterior visual pathways.
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Biomedical subjects
Publications and source records attributed to A M Halliday.
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The diagnostic value of the pattern-evoked response has been assessed in 73 patients referred because of suspected multiple sclerosis. Altogether 52 had delayed responses. Fifty-one patients in the group satisfied McAlpine's criteria for diagnosing definite, probable, or possible multiple sclerosis. Of these, all but two had delayed responses in one or both eyes, while only three of the remaining 22 patients had delays. In those patients with multiple sclerosis but without any history of optic neuritis the incidence of delayed responses was only slightly less. Of 51 patients with delayed responses 23 had normal discs. Thus subclinical lesions of the visual pathways can be readily detected with this test. The high incidence of abnormal pattern responses, even in patients with no other ocular signs or symptoms, suggests that the test is of value in establishing the diagnosis.
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1. Averaged responses have been recorded from an array of ten scalp electrodes over the occipital cortex in man to the reversal of a black-and-white checkerboard pattern, presented in different octants of the visual field.2. In all subjects a prominent wave was seen, with a peak latency of about 100 msec, which showed consistent and systematic changes with variation in the position of the stimulus in the visual field.3. With stimulation of the octants next to the vertical meridian, this component was of large amplitude, while with stimulation of the octants next to the horizontal meridian, it was small and inconspicuous.4. With upper field octants, the peak at 100 msec was surface-negative, while with lower field octants it was reversed in polarity.5. The occipital response was largest 5 or 7.5 cm above the inion, and the amplitude recorded 3 cm lateral to the mid line was larger over the hemisphere contralateral to the half field being stimulated than ipsilaterally.6. These findings are discussed in relation to the underlying anatomy of the visual cortex, and it is concluded that these responses are likely to arise mainly from extra-striate areas.
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