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Brainstem auditory evoked potentials and somatosensory evoked potentials in prediction of posttraumatic coma in
1Institute of Clinical Neurophysiology, University Medical Center, Ljubljana, Slovenia.
Insights
Brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) studies can predict outcomes in children with severe head injuries. Normal evoked potential studies indicate a good prognosis, while absent potentials reliably predict a fatal outcome.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Critical Care Medicine
Background:
- Severe head injury in children can lead to posttraumatic coma with uncertain prognoses.
- Predicting outcomes (quo ad vitam) is crucial for clinical management and family counseling.
- Evoked potentials offer objective measures of neurological function.
Purpose of the Study:
- To evaluate the predictive value of follow-up brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) studies for outcomes in children with severe head injury.
- To determine if electrophysiological findings can reliably predict survival or brain death in pediatric posttraumatic coma.
Main Methods:
- 127 children with severe head injury (Glasgow Coma Scale score ≤ 8) underwent follow-up BAEP and SEP studies within 72 hours of admission.
- Outcomes were categorized as brain death or survival.
- Electrophysiological findings were correlated with clinical outcomes.
Main Results:
- 50 children with normal BAEPs and SEPs had a 78% survival rate.
- 45 children with abnormal findings showed a 69% survival rate.
- 32 children with absent recordable BAEPs and SEPs all died, indicating a 100% mortality rate.
Conclusions:
- Normal evoked potential studies in comatose children with severe head injury are associated with a good prognosis (78% survival).
- Absent evoked potentials reliably predict a fatal outcome in this population.
- BAEP and SEP studies are valuable tools for predicting quo ad vitam outcomes in pediatric severe head injury.
Abstract:
Follow-up brainstem auditory evoked potential (BAEP) and somatosensory evoked potential (SEP) studies were performed within 72 hours after admission in 127 children with severe head injury (Glasgow Coma Scale score of < or = 8) in order to predict quo ad vitam outcome of posttraumatic coma. Outcomes were categorised as brain death and survival. On first assessment 50 comatose children had normal BAEPs and SEPs. 78% of them survived and 22% deteriorated and died. 45 had abnormal findings. 69% of them improved and survived whilst 31% deteriorated and died. 32 children did not have recordable BAEPs and SEPs. All of them died. Thus, comatose children with normal EP studies have in 78% good prognosis and a bad outcome can be reliably predicted.