Visual–perceptual impairment in children with periventricular leukomalacia

We set out to define visuo-perceptual impairment related to periventricular leukomalacia (PVL) using the Developmental Test of Visual Perception (DTVP). Correlations were sought between visual–perceptual deficits and DTVP profile and neuroradiological and neurophthalmological findings. The DTVP was administered to 20 children (m/f: 10/10), aged between 5 and 8 years (mean: 6.95 years), presenting with: spastic diplegia; PVL documented by brain MRI; normal or mildly impaired visual acuity; mild-moderate upper limb functional impairment. The mean General Visual–Perceptual Quotient was impaired, showing a great variability among the patients. Despite this, an uneven DTPV profile, characterised by a significant difference between the VMIQ and the Non-Motor Visual–Perceptual Quotient (P<0.001), and a poor result on the Closure subtest (identification of whole figures from incomplete visual information) was observed in all the subjects. This profile reflects a deficit in eye–hand coordination and in praxic-constructional abilities and could be the expression of malfunctioning of the occipital–parietal pathway of visual integration, the so-called ‘dorsal stream,’ a hypothesis reinforced by the emergence of a statistically significant correlation between the neuroradiological data and the presence of visual–perceptual impairment.