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Use of evoked potentials in preterm neonates
M J Taylor1, E Saliba, J Laugier
1INSERM Unité 316, et Centre de Pédiatrie Gatien de Clocheville, Tours, France.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|January 1, 1996
Summary
Evoked potentials offer a valuable method for monitoring central nervous system development in premature infants. Normative values, considering gestational and postnatal age, are crucial for assessing neurological maturation and predicting outcomes like cerebral palsy.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Clinical Electrophysiology
Background:
- Assessing neurological development in premature infants is challenging due to difficulties in obtaining reliable clinical evaluations.
- Evoked potentials (EPs) reflect the functional status of the central nervous system (CNS) and show significant maturational changes in early life.
- Maturational changes in EPs, including latency and morphology, provide objective markers for CNS development.
Purpose of the Study:
- To review techniques for recording evoked potentials in premature infants.
- To discuss the early developmental changes and maturational patterns of evoked potentials.
- To highlight the clinical utility of evoked potentials in assessing and monitoring neurological development in preterm neonates.
Main Methods:
- Review of existing literature on evoked potential recording techniques in premature infants.
- Analysis of maturational changes in various evoked potential types, including morphological and latency shifts.
- Examination of the predictive value of specific evoked potentials (e.g., SEPs, BAEPs) for neurological outcomes.
Main Results:
- Evoked potential maturational changes provide an invaluable means for assessing and monitoring CNS development.
- Normative values for EPs must account for both gestational and postnatal age.
- Median nerve Somatosensory Evoked Potentials (SEPs) recorded in the second week of life can predict cerebral palsy in preterm infants at risk of periventricular leukomalacia (PVL).
- Brainstem Auditory Evoked Potentials (BAEPs) require further study in specific conditions like apnoeic preterm babies.
Conclusions:
- Evoked potentials are increasingly valuable clinical tools for assessing preterm neonates, offering objective CNS assessment.
- Specific EPs, like PTN SEPs, show promise as reliable indicators of outcome, though technical challenges exist.
- Evoked potentials can aid in assessing gestational age, monitoring in utero and postnatal development, and evaluating treatment modalities.