[Multimodal evoked potentials and the blink reflex in patients with primary brainstem lesions]

In 17 patients with primary brainstem injury, out of 60 patients with severe head trauma, diagnostic and prognostic values of multimodal evoked potentials and blink reflex were evaluated in relation to clinical syndromes of the brainstem, the duration of coma and the outcome. Clinical classification of the brainstem syndromes according to Gerstenbrand and Rumpl was used for the evaluation of the clinical findings, the Innsbruck Coma Scale (ICS) for the evaluation of the coma level, and the Glasgow Outcome Scale (GOS) for the outcome. Analyses and measurements of the multimodal evoked potentials and blink reflex were used many times in the period of assessment (six months after the injury). The analysis of our results with multimodal evoked potentials and blink reflex revealed different correlation and sensitivity in relation to the clinical syndromes of the brainstem, the duration of coma and the outcome of the injury. The blink reflex and somatosensory evoked potentials had the best correlation and the greatest sensitivity, the auditory evoked potentials had somewhat, while the visual evoked potentials had none. Multimodal evoked potentials and blink reflex increase the specificity of the diagnosis of brainstem injury compared to clinical observation only, and improve prognostic reliability.