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Related Experiment Videos

Evoked potentials in comatose children: auditory brainstem responses.

L J De Meirleir1, M J Taylor

  • 1Division of Neurology, Hospital for Sick Children, University of Toronto, Ontario, Canada.

Pediatric Neurology
|January 1, 1986
PubMed
Summary
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Auditory brainstem responses (ABRs) in comatose children did not reliably predict outcomes. Many children with normal ABRs had poor prognoses, suggesting ABRs are not effective early prognostic indicators.

Area of Science:

  • Pediatric Neurology
  • Neurophysiology

Background:

  • Coma in children is a critical condition requiring accurate prognostic tools.
  • Auditory brainstem responses (ABRs) assess auditory pathway function and have been explored for prognostic value in comatose patients.

Purpose of the Study:

  • To retrospectively evaluate the utility of Auditory Brainstem Responses (ABRs) as an early predictor of neurological outcome in children with coma.

Main Methods:

  • Retrospective analysis of ABRs in 80 children (4 days to 19 years) with coma of diverse etiologies.
  • ABRs were performed shortly after admission and correlated with initial neurological status and final outcomes.
  • Analysis included Glasgow Coma Scale scores, ABR abnormalities (normal, abnormal, absent waves), and interpeak latencies.

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Main Results:

  • Among 49 patients with Glasgow Coma Scale < 7, only 21 had severely abnormal ABRs; 18 had normal ABRs, but 10 died and 8 had neurological deficits.
  • Prolonged interpeak latencies were observed in 16 patients across various clinical severities.
  • Of 17 children with absent ABRs or only waves I/III, three survived with minimal deficits or in a vegetative state.

Conclusions:

  • The study did not confirm the efficacy of ABRs as an early prognostic indicator in comatose children.
  • Normal ABR findings in some severely ill children suggest limitations in predicting outcomes.
  • Further research may be needed to refine the role of ABRs in pediatric coma prognostication.