Normalisation of visual evoked potentials after optic neuritis

Abstract

Normalisation of the visual evoked potential (VEP) in patients with optic neuritis (ON) appears to be a rare phenomenon. However, although several workers have indicated that it can happen, they have not followed up with subsequent VEP tests to confirm how long the VEP latency of the affected eye remains in the normal range. To resolve this, 18 patients with a clinical diagnosis of acute unilateral ON were followed for 5 years with repeated VEP tests to determine if the latency of the P₂ wave from affected eye could return to the normal range. Furthermore, in cases where the latency returned to normal, the length of time that it remained so was also assessed. The normal range for the latency of the P₂ wave was determined by measuring VEPs from a group of 18 healthy control subjects with a similar age distribution to the patients. This established an upper limit of 115.9 ms. At presentation the mean P₂ latency of the affected eyes of the patients was 140 ms with a standard deviation of 16 ms. In general, the VEP latencies remained constant over the period of the investigation. However two patients demonstrated a return to normal latencies but this was only temporary. Their latencies become prolonged again within 2 years. These results provide evidence that the delayed P₂ latency observed in patients with ON can return to the normal range in a small percentage of cases. However, this improvement may spontaneously deteriorate once more as a result of further episodes of subacute demyelination.