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Somatosensory Event-related Potentials from Orofacial Skin Stretch Stimulation
Published on: December 18, 2015
The middle-latency components of somatosensory evoked potentials help to predict the outcome in of post-anoxic coma:
Riccardo Carrai1, Maddalena Spalletti1, Maenia Scarpino1
1SODc Neurophysiopathology, Careggi Teaching Hospital, Florence, Italy.
Objective:
To evaluate whether middle-latency-somatosensory evoked potentials (MLSEPs) can help to predict outcome in coma after cardiac arrest (CA).
Methods:
We conducted a retrospective evaluation of comatose patients after CA. MLSEPs were recorded during the first 12hs and after 72hs. No evolutionary analysis was done between these two patient groups. The outcome was evaluated using the cerebral performance category score achieved 6 months after CA.
Results:
We retrospectively reviewed the records of 325 patients; of whom 248 were analyzed. Of these, 137 had SEP tests in the first 12 h, and 142 had them at 72hs. The two patient groups were analyzed separately and no evolutionary evaluation was made. At 12hs, the presence of MLSEPs associated with N20-P25 > 4.0 μV has a high prognostic value for predicting the recovery of consciousness (CPC1-3) (FPR:0.0%;-0.0-4.7;-95%ICs- and ACC:78.6-70.6-85.3;-95%ICs-). At 72 h, the absence of these components has high predictive value for severe disability (CPC 3-5), (FPR: 0.0%; 0.0-14.2; 95% CI and ACC: 73.6%; 64.8-81.2; 95% CI).
Conclusions:
At 12hs after CA, the presence of MLSEPs with cortical SEPs N20-P25 > 4 μV indicates a recovery of consciousness. Conversely, the absence at 72hs after CA, predicts severe disability.
Significance:
MLSEP incorporated into a multimodal prognostic pathway, may be a useful support tool in outcome prediction of post-anoxic coma.
