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PSVER (70-min check size) P100 absolute latency 104 118 Intereye difference 2 8 BAER (60 dBSL, 10/s monaural stimuli) Interwave latency I III 21 26 III V 19 24 I V 40 47 Interside difference for most 01 04 latencies SEP median nerve (wrist stimulation) Absolute latency Erb s point 97 120 P/N 13 (cervicomedullary) 135 163 N 19/P 21 (cortical) 190 221 Interwave latency Erb s-P/N 13 38 52 P/N 13 N 19 55 68 Interside difference P/N 13 N 19 03 11 SEP tibial nerve (ankle stimulation; Fz-Cz recording; 165-cm height; absolute latencies are shorter for stimulation at the knee) Absolute latency Lumbar point (cauda equina) 20 25 N/P 37 (cortex) 36 425 Interwave latency Lumbar N/P 37 164 216 Interside difference Lumbar N/P 37 07 19

Norms must be veri ed in each laboratory; in most instances they are sensitive to the technique and stimulus used and height of the patient in the cases of limb stimulation PSVER, pattern shift visual evoked response; BAER, brainstem auditory evoked response; SSEP, somatosensory evoked response

To demonstrate enhancing the line chart type, we can take the same information we have in the other chart and switch from using yearly data to using period data In the Chart Designer, change the chart type to Line and then go into the different series, Series1, 2, and 3, and adjust the format of the line and the marker To help focus the business user on each line, we can change the color and the width of the lines and also increase the size of the marker, as shown here

ible waveform over the occipital lobes In the EEG, such responses to fast rates of stimulation are referred to as the occipital driving response (Fig 2-3B and C) In 1969, Regan and Heron observed that a visual evoked response could be produced by the sudden change of a viewed checkerboard pattern The responses produced by rapidly repeating the pattern reversal, were easier to detect and measure than ash responses and more consistent in waveform from one individual to another It became apparent that this type of stimulus, applied rst to one eye and then to the other, could demonstrate conduction delays in the visual pathways of patients who had formerly suffered a disease of the optic nerve even when there were no residual signs of reduced visual acuity, visual eld abnormalities, alterations of the optic nerve head, or changes in pupillary re exes This procedure, called pattern-shift visual evoked responses (PSVER, or VER) or pattern-reversal visual evoked potentials, has been widely adopted as one of the most delicate tests of lesions in the visual system Figure 2-4 illustrates the normal PSVER and two types of delayed responses Usually, abnormalities in the amplitude and duration of PSVER accompany the abnormally prolonged latencies, but they are dif cult to quantify The expected latency for the positive polarity PSVER is near 100 ms (thus the term P 100 ); an absolute latency over approximately 118 ms or a difference in latencies of greater than 9 ms between the two eyes signi es involvement of one optic nerve (Table 2-4) Bilateral prolongation of latencies, demonstrated by separate stimulation of each eye, can be due to lesions in both optic nerves, the optic chiasm, or the visual pathways posterior to the chiasm

Figure 2-4 Pattern-shift visual evoked responses (PSVERs) Latency measured to rst major positive peak (termed P100 because of its latency from the stimulus of approximate 100 msec) Upper two tracings: These, from the right and left eyes, are normal Middle tracings: PSVER from the right eye is normal but the latency of the response from the left eye is prolonged and its duration is increased Lower tracings: PSVER from both eyes show abnormally prolonged latencies, somewhat greater on the left than on the right Calibration: 50 ms, 25 mV (Adapted by permission from Shahrokhi et al)

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