Delayed visual perception and delayed visual evoked potentials in the spinal form of multiple sclerosis and in retrobulbar neuritis. 1976

D Regan, and B A Milner, and J R Heron

(1) We have used both subjective and evoked potential tests to study cases of multiple sclerosis with no history of retrobulbar neuritis (spinal patients) and compared them with patients with multiple sclerosis who had experienced an attack of retrobulbar neuritis (RBN). We measured the delay of steady-state evoked potentials (EPs) elicited by flicker in the medium-frequency (13-25 c/s) range, by flicker in the high-frequency (30-60 c/s) range, and by pattern-reversal. We also measured the delay in seeing (perceiving) both an increase of light intensity and a decrease of light intensity. (2) The difference between perceptual delays for the left and right eyes (D s) was abnormal when retrobulbar neuritis affected only one eye (22/22 patients) even when acuity and discs were normal. It might be supposed that this perceptual test would be ineffective when both eyes were affected by retrobulbar neuritis. However, the value of D was abnormal in cases of bilateral retrobulbar neuritis (5/5 patients). Probably the principal reason is that demyelination was patchy in the patients studied. For this same reason the difference between perceptual delays for two sites in the visual field (T s) may also be abnormal. In principle the perceptual delay test can be effective even when both eyes are similarly delayed: abnormal values of T were recorded in 5 spinal patients for whom D was normal. (3) Perceptual delays were measured for an extended group of 19 patients suffering from spinal multiple sclerosis. Taking both D and T into account, the perceptual delay test alone picked out 12/19 spinal patients. The perceptual delay test has the advantage over EP tests that it can detect islands of demyelination as small as 3 degrees diameter, and the apparatus is cheap and straightforward to use. (4) Thirteen patients with spinal multiple sclerosis, including 6 with no ocular signs or symptoms, were examined with a battery of two evoked potential and one perceptual test. Ten patients had clearly abnormal visual delays. Results for the remaining 3 were equivocal. Delay tests can reveal visual damage in most patients who have not experienced an attack of RBN as well as in practically all patients who have experienced an attack. (5) Correlations between the results of the various tests were different in spinal patients and in multiple sclerosis patients who had experienced an attack of retrobulbar neuritis. Flicker EPs, pattern EPs and visual perception were all delayed in every RBN patient, whereas for spinal patients different tests could pick up different patients. Flicker EPs picked up 5/13 spinal patients, pattern EPs 6/13, perceptual delay (D) picked up 4/13 and perceptual delay T picked up 7/13. (6) Delay tests divided spinal multiple sclerosis patients into two fairly distinct groups. In one group pattern EPs and perception were delayed; in the other group flicker EPs were delayed. This grouping corresponded to a clinical distinction between long-standing patients with visual signs and recent patients without visual signs...

UI MeSH Term Description Entries
D008027 Light That portion of the electromagnetic spectrum in the visible, ultraviolet, and infrared range. Light, Visible,Photoradiation,Radiation, Visible,Visible Radiation,Photoradiations,Radiations, Visible,Visible Light,Visible Radiations
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009103 Multiple Sclerosis An autoimmune disorder mainly affecting young adults and characterized by destruction of myelin in the central nervous system. Pathologic findings include multiple sharply demarcated areas of demyelination throughout the white matter of the central nervous system. Clinical manifestations include visual loss, extra-ocular movement disorders, paresthesias, loss of sensation, weakness, dysarthria, spasticity, ataxia, and bladder dysfunction. The usual pattern is one of recurrent attacks followed by partial recovery (see MULTIPLE SCLEROSIS, RELAPSING-REMITTING), but acute fulminating and chronic progressive forms (see MULTIPLE SCLEROSIS, CHRONIC PROGRESSIVE) also occur. (Adams et al., Principles of Neurology, 6th ed, p903) MS (Multiple Sclerosis),Multiple Sclerosis, Acute Fulminating,Sclerosis, Disseminated,Disseminated Sclerosis,Sclerosis, Multiple
D009902 Optic Neuritis Inflammation of the optic nerve. Commonly associated conditions include autoimmune disorders such as MULTIPLE SCLEROSIS, infections, and granulomatous diseases. Clinical features include retro-orbital pain that is aggravated by eye movement, loss of color vision, and contrast sensitivity that may progress to severe visual loss, an afferent pupillary defect (Marcus-Gunn pupil), and in some instances optic disc hyperemia and swelling. Inflammation may occur in the portion of the nerve within the globe (neuropapillitis or anterior optic neuritis) or the portion behind the globe (retrobulbar neuritis or posterior optic neuritis). Neuropapillitis,Retrobulbar Neuritis,Anterior Optic Neuritis,Posterior Optic Neuritis,Anterior Optic Neuritides,Neuritides, Anterior Optic,Neuritides, Optic,Neuritides, Posterior Optic,Neuritides, Retrobulbar,Neuritis, Anterior Optic,Neuritis, Optic,Neuritis, Posterior Optic,Neuritis, Retrobulbar,Neuropapillitides,Optic Neuritides,Optic Neuritides, Anterior,Optic Neuritides, Posterior,Optic Neuritis, Anterior,Optic Neuritis, Posterior,Posterior Optic Neuritides,Retrobulbar Neuritides
D005071 Evoked Potentials Electrical responses recorded from nerve, muscle, SENSORY RECEPTOR, or area of the CENTRAL NERVOUS SYSTEM following stimulation. They range from less than a microvolt to several microvolts. The evoked potential can be auditory (EVOKED POTENTIALS, AUDITORY), somatosensory (EVOKED POTENTIALS, SOMATOSENSORY), visual (EVOKED POTENTIALS, VISUAL), or motor (EVOKED POTENTIALS, MOTOR), or other modalities that have been reported. Event Related Potential,Event-Related Potentials,Evoked Potential,N100 Evoked Potential,P50 Evoked Potential,N1 Wave,N100 Evoked Potentials,N2 Wave,N200 Evoked Potentials,N3 Wave,N300 Evoked Potentials,N4 Wave,N400 Evoked Potentials,P2 Wave,P200 Evoked Potentials,P50 Evoked Potentials,P50 Wave,P600 Evoked Potentials,Potentials, Event-Related,Event Related Potentials,Event-Related Potential,Evoked Potential, N100,Evoked Potential, N200,Evoked Potential, N300,Evoked Potential, N400,Evoked Potential, P200,Evoked Potential, P50,Evoked Potential, P600,Evoked Potentials, N100,Evoked Potentials, N200,Evoked Potentials, N300,Evoked Potentials, N400,Evoked Potentials, P200,Evoked Potentials, P50,Evoked Potentials, P600,N1 Waves,N2 Waves,N200 Evoked Potential,N3 Waves,N300 Evoked Potential,N4 Waves,N400 Evoked Potential,P2 Waves,P200 Evoked Potential,P50 Waves,P600 Evoked Potential,Potential, Event Related,Potential, Event-Related,Potential, Evoked,Potentials, Event Related,Potentials, Evoked,Potentials, N400 Evoked,Related Potential, Event,Related Potentials, Event,Wave, N1,Wave, N2,Wave, N3,Wave, N4,Wave, P2,Wave, P50,Waves, N1,Waves, N2,Waves, N3,Waves, N4,Waves, P2,Waves, P50
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014796 Visual Perception The selecting and organizing of visual stimuli based on the individual's past experience. Visual Processing,Perception, Visual,Processing, Visual

Related Publications

D Regan, and B A Milner, and J R Heron
January 1977, Neurologia i neurochirurgia polska,
D Regan, and B A Milner, and J R Heron
February 1984, Archives of neurology,
D Regan, and B A Milner, and J R Heron
April 1983, Revue medicale de la Suisse romande,
D Regan, and B A Milner, and J R Heron
February 1978, Lancet (London, England),
D Regan, and B A Milner, and J R Heron
September 1981, Klinische Monatsblatter fur Augenheilkunde,
D Regan, and B A Milner, and J R Heron
July 2017, Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,
D Regan, and B A Milner, and J R Heron
September 1976, British medical journal,
D Regan, and B A Milner, and J R Heron
February 2007, Journal of the Medical Association of Thailand = Chotmaihet thangphaet,
D Regan, and B A Milner, and J R Heron
September 2018, Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society,
Copied contents to your clipboard!