Prognostic value of flash visual evoked potentials in preterm infants

This paper investigates the prognostic value of flash visual evoked potenti als (VEPs) recorded in preterm infants at birth and at term age with respec t to severe neurological outcome. Flash VEPs were recorded in 81 preterm in fants at birth (i.e. <35 weeks' gestation) and repeated in 56 of these infa nts at term age. The preterm infants were assigned to either a healthy or a t-risk subgroup based on clinical birth factors. Normal ranges of flash-VEP latencies, amplitudes, and number of components present were obtained from the subgroup of healthy preterm infants and from 68 term infants tested po stnatally. The flash-VEP results of the entire preterm group were compared with the normal ranges and any abnormalities noted. Seven preterm infants i n the at-risk group died, six of whom had abnormal flash VEPs before term a ge. Of the five infants from the at-risk group diagnosed with cerebral pals y (CP), three had abnormal flash VEPs before term age. Thus the sensitivity and specificity of the flash VEP with respect to survival was 86% and 89% respectively, and with respect to the development of CP was 60% and 92%. Th e abnormal features of the flash VEP associated with adverse outcomes compr ised a delayed N3 component before term age and the absence of a positive c omponent (P2) at term age.