Our aim is to elaborate the clinical significance of giant amplitude pattern reversal visual evoked potentials (VEPs) in children. ‘Giant’ amplitude VEPs exceed the upper 97.5^th centile, 90% CI for age. We scrutinised 2750 pattern VEPs recorded to international standards between Jan 2015 and 2017 from children aged 16 years and under, attending a specialist children's hospital. Twenty seven children, median age 6yrs, (range 1–16 yrs), were identified with giant VEPs (P100 amplitude range 65–163 μV). Most, 22/27 (81%), had conditions associated with a risk of raised ICP. Sixteen of these twenty two children had craniosynostosis; six multi-sutural and eight single suture disease. Others had Idiopathic Intracranial Hypertension, arachnoid cyst, NF1 with shunted hydrocephalus, chronic infantile neurological cutaneous and articular (CINCA) syndrome, nephrotic cystinosis and obstructive sleep apnoea. Five children presented with a range of conditions, some associated with seizures some symptomatic, but as yet undiagnosed. Frequent structural associations were optical coherence tomography measures of optic disc maximum anterior axial horizontal retinal thickness projection >160 μm and neuro-radiological findings of CSF effacement and copper beaten appearance. Ultrasonography measures of optic nerve sheath diameters varied, but in one child took 2 years to resolve after treatment for raised ICP. Optic disc gradings by fundoscopy were mostly normal, as were visual acuities. Raised ICP was confirmed by gold standard ICP bolt measurements in five of seven children tested. These data suggest that rICP should be considered if a child has sustained giant amplitude VEPs at normal latency.

我们的目的是阐述巨幅模式反转视觉诱发电位（VEPs）在儿童中的临床意义。“巨幅” VEP 超过上限 97.5 ^th百分位数，年龄的 90% CI。我们仔细检查了 2015 年 1 月至 2017 年 16 岁及以下儿童在专科儿童医院就诊的 2750 例符合国际标准的 VEP。27 名中位年龄为 6 岁（范围 1-16 岁）的儿童被鉴定为具有巨大 VEP（P100 振幅范围 65-163 μV）。大多数 22/27 (81%) 的人患有与 ICP 升高风险相关的疾病。这 22 名儿童中有 16 名患有颅缝早闭；六多缝线和八单缝线病。其他人患有特发性颅内高压、蛛网膜囊肿、NF1 伴分流性脑积水、慢性婴儿神经皮肤和关节 (CINCA) 综合征、肾病性胱氨酸病和阻塞性睡眠呼吸暂停。五名儿童出现了一系列疾病，其中一些与癫痫发作有关，一些有症状，但尚未确诊。常见的结构关联是视盘最大前轴水平视网膜厚度投影> 160μm的光学相干断层扫描测量以及脑脊液消失和铜打样外观的神经放射学发现。视神经鞘直径的超声测量值各不相同，但有一名儿童在治疗 ICP 升高后需要 2 年时间才能解决。眼底镜检查的视盘分级大多正常，视力也正常。在测试的七名儿童中，有五名通过金标准 ICP 螺栓测量确认了升高的 ICP。这些数据表明，如果儿童在正常潜伏期持续存在巨幅 VEP，则应考虑 rICP。160 μm 和 CSF 消失和铜打样外观的神经放射学发现。视神经鞘直径的超声测量值各不相同，但有一名儿童在治疗 ICP 升高后需要 2 年时间才能解决。眼底镜检查的视盘分级大多正常，视力也正常。在测试的七名儿童中，有五名通过金标准 ICP 螺栓测量确认了升高的 ICP。这些数据表明，如果儿童在正常潜伏期持续存在巨幅 VEP，则应考虑 rICP。160 μm 和 CSF 消失和铜打样外观的神经放射学发现。视神经鞘直径的超声测量值各不相同，但有一名儿童在治疗 ICP 升高后需要 2 年时间才能解决。眼底镜检查的视盘分级大多正常，视力也正常。在测试的七名儿童中，有五名通过金标准 ICP 螺栓测量确认了升高的 ICP。这些数据表明，如果儿童在正常潜伏期持续存在巨幅 VEP，则应考虑 rICP。在测试的七名儿童中，有五名通过金标准 ICP 螺栓测量确认了升高的 ICP。这些数据表明，如果儿童在正常潜伏期持续存在巨幅 VEP，则应考虑 rICP。在测试的七名儿童中，有五名通过金标准 ICP 螺栓测量确认了升高的 ICP。这些数据表明，如果儿童在正常潜伏期持续存在巨幅 VEP，则应考虑 rICP。