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Brain-stem Auditory Evoked Potentials and Early Somatosensory Evoked Potentials in Neurointensively Treated Comatose Children

Brain-stem Auditory Evoked Potentials and Early Somatosensory Evoked Potentials in... Abstract • Forty-three comatose children treated by invasive neurointensive care were examined by brain-stem auditory evoked potentials (BAEPs) and somatosensory evoked potentials (SEPs). The evoked potential (EP) results obtained were reviewed in conjunction with the clinical outcome. As a BAEP criterion, the V-I interpeak latency and, as an SEP criterion, the central conduction time (N20-N14) latency) were measured. A loss of BAEP and SEP components portended a poor prognosis. On the other hand, latency prolongations were seen in a third of patients who made a complete recovery. However, the SEP and BAEP have proved themselves as reliable methods in the judgment of the clinical state and the prognosis of intensively treated children with a hypoxic-ischemic encephalopathy or a head injury. The measurement of both BAEPs and SEPs was a more reliable prognostic aid than either EP measurement alone. (Am J Dis Child 1983;137:421-426) References 1. Plum F, Posner JB: Diagnosis of Stupor and Coma . Philadelphia, FA Davis Co, 1980. 2. Jennet B, Teasdale G: Management of Head Injuries . Philadelphia, FA Davis Co, 1981. 3. Teasdale G, Jennet B: Assessment of coma and impaired consciousness . Lancet 1974;2:81-84.Crossref 4. Pfenninger J, Kaiser G: Die kontinuierliche intrakranielle Drucküberwachung und neue Aspekte der Neurointensivpflege beim Kind . Schweiz Med Wochenschr 1979;109:1693-1699. 5. Miller JD: Barbiturates and raised intracranial pressure . Ann Neurol 1979;6:189-193.Crossref 6. Sumskii LI, Sklooskaya ML: Topography of the visual evoked potentials in normal and comatose subjects . Hum Physiol 1979;5:51-56. 7. Greenberg RP, Mayer DJ, Becker PD, et al: Evaluation of brain function in severe human head trauma with multimodality evoked potentials . J Neurosurg 1977;47:150-162.Crossref 8. Greenberg RP, Becker PD, Miller JD, et al: Evaluation of brain function in severe human head trauma with multimodality evoked potentials . J Neurosurg 1977;47:163-177.Crossref 9. Tsubokawa T, Nishimoto H, Yamamoto T, et al: Assessment of brainstem damage by the auditory brainstem response in acute severe head injury . J Neurol Neurosurg Psychiatry 1980;43: 1005-1011.Crossref 10. Jewett D, Williston JS: Auditory-evoked far fields averaged from the scalp of humans . Brain 1971;94:681-696.Crossref 11. Picton TW, Hillyard SA, Krausz HI, et al: Human auditory evoked potentials: Evaluation of components . Electroencephalogr Clin Neurophysiol 1974;36:179-190.Crossref 12. Starr A, Hamilton AE: Correlations between confirmed sites of neurological lesions and abnormalities of far field auditory brainstem responses . Electroencephalogr Clin Neurophysiol 1976;41:594-608.Crossref 13. Hashimoto I, Ishiyama Y, Yoshimoto T, et al: Brain-stem auditory evoked potentials recorded directly from human brain-stem and thalamus . Brain 1981;104:841-859.Crossref 14. Allison T, Goff WR, Williamson D, et al: On the neural origin of early components of the human somatosensory evoked potentials , in Desmedt JE (ed): Clinical Uses of Cerebral Brainstem and Spinal Somatosensory Evoked Potentials . New York, S Karger AG, 1981, pp 51-68. 15. Teasdale G, Jennet B: Assessment and prognosis of coma after head injury . Acta Neurochir 1976;34:45-55.Crossref 16. Kooi KA: Fundamentals of Electroencephalography . Hagerstown, Md, Harper & Row Publishers Inc, 1971. 17. Hume AL, Cant BR, Shaw NA: Central somatosensory conduction time in comatose patients . Ann Neurol 1979;5:379-384.Crossref 18. Hume AL, Cant BR: Central somatosensory conduction after head injury . Ann Neurol 1981;10:411-419.Crossref 19. Kaga K, Takigucki T, Myokai K, et al: Effect of deep hypothermia and circulatory arrest on the auditory brain stem responses . Arch Otorhinolaryngol 1979;225:199-205.Crossref 20. Stockard JJ, Sharbrough FW, Tinker JA: Effects of hypothermia on the human brainstem auditory response . Ann Neurol 1978;3:368-370.Crossref 21. Guerit J, Meulders M: Clinical application of the quantification of the relationship between body temperature and brain stem auditory evoked potentials. Read before the Tenth International Congress of Electroencephalography and Clinical Neurophysiology, Kyoto, Japan, Sept 14, 1981. 22. Stejskal L, Travnicek K, Sonrek K, et al: Somatosensory evoked potentials in deep hypothermia . Appl Neurophysiol 1980;43:1-7. 23. Hecox K, Cone B, Blaw M: Brainstem auditory evoked response in the diagnosis of pediatric neurologic diseases . Neurology 1981;31:832-840.Crossref 24. Seales DM, Torkelson RD, Shuman RM, et al: Abnormal brainstem auditory evoked potentials and neuropathology in 'locked in syndrome.' Neurology 1981;31:893-896.Crossref 25. Lindsay KW, Carlin J, Kennedy I, et al: Evoked potentials in severe head injury: Analysis and relation to outcome . J Neurol Neurosurg Psychiatry 1981;44:796-802.Crossref 26. Miltner FD, Haves E, Bushe KA: Prognostic aspects of electroclinical and neuroendocrine data in severe brain injury . Acta Neurochir Suppl 1979;28:43-49. 27. Trojaborg W, Jorgenson ED: Evoked cortical potentials in patients with 'isoelectric' EEG's . Electroencephalogr Clin Neurophysiol 1973;35: 301-309.Crossref 28. Starr A: Auditory brainstem responses in brain death . Brain 1976;99:543-554.Crossref 29. Prichard JW: Barbiturates: Physiological effects , in Glaser GH, Penry JK, Woodbury DM (eds): Antiepileptic Drugs . New York, Raven Press, 1980, pp 505-522. 30. Stockard JJ, Rossiter VS: Clinical and pathological correlates of brainstem auditory response abnormalities . Neurology 1977;27: 316-325.Crossref 31. Seales DM, Rossiter VS, Weinstein ME, et al: Brainstem auditory evoked responses in patients comatose as a result of blunt head injury . J Trauma 1971;19:347-353.Crossref 32. Benezech J, Rerebeau P, Privat JM, et al: Apport des potentiels évoqués du tronc cérébral (PET) pour l'étude clinique et le prognostic des comas traumatiques . Neurochirurgie 1979;25: 219-223. 33. Allen A, Starr A: Auditory brainstem potentials in monkey and man . Electroencephalogr Clin Neurophysiol 1978;45:53-63.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Brain-stem Auditory Evoked Potentials and Early Somatosensory Evoked Potentials in Neurointensively Treated Comatose Children

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References (37)

Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1983.02140310003001
Publisher site
See Article on Publisher Site

Abstract

Abstract • Forty-three comatose children treated by invasive neurointensive care were examined by brain-stem auditory evoked potentials (BAEPs) and somatosensory evoked potentials (SEPs). The evoked potential (EP) results obtained were reviewed in conjunction with the clinical outcome. As a BAEP criterion, the V-I interpeak latency and, as an SEP criterion, the central conduction time (N20-N14) latency) were measured. A loss of BAEP and SEP components portended a poor prognosis. On the other hand, latency prolongations were seen in a third of patients who made a complete recovery. However, the SEP and BAEP have proved themselves as reliable methods in the judgment of the clinical state and the prognosis of intensively treated children with a hypoxic-ischemic encephalopathy or a head injury. The measurement of both BAEPs and SEPs was a more reliable prognostic aid than either EP measurement alone. (Am J Dis Child 1983;137:421-426) References 1. Plum F, Posner JB: Diagnosis of Stupor and Coma . Philadelphia, FA Davis Co, 1980. 2. Jennet B, Teasdale G: Management of Head Injuries . Philadelphia, FA Davis Co, 1981. 3. Teasdale G, Jennet B: Assessment of coma and impaired consciousness . Lancet 1974;2:81-84.Crossref 4. Pfenninger J, Kaiser G: Die kontinuierliche intrakranielle Drucküberwachung und neue Aspekte der Neurointensivpflege beim Kind . Schweiz Med Wochenschr 1979;109:1693-1699. 5. Miller JD: Barbiturates and raised intracranial pressure . Ann Neurol 1979;6:189-193.Crossref 6. Sumskii LI, Sklooskaya ML: Topography of the visual evoked potentials in normal and comatose subjects . Hum Physiol 1979;5:51-56. 7. Greenberg RP, Mayer DJ, Becker PD, et al: Evaluation of brain function in severe human head trauma with multimodality evoked potentials . J Neurosurg 1977;47:150-162.Crossref 8. Greenberg RP, Becker PD, Miller JD, et al: Evaluation of brain function in severe human head trauma with multimodality evoked potentials . J Neurosurg 1977;47:163-177.Crossref 9. Tsubokawa T, Nishimoto H, Yamamoto T, et al: Assessment of brainstem damage by the auditory brainstem response in acute severe head injury . J Neurol Neurosurg Psychiatry 1980;43: 1005-1011.Crossref 10. Jewett D, Williston JS: Auditory-evoked far fields averaged from the scalp of humans . Brain 1971;94:681-696.Crossref 11. Picton TW, Hillyard SA, Krausz HI, et al: Human auditory evoked potentials: Evaluation of components . Electroencephalogr Clin Neurophysiol 1974;36:179-190.Crossref 12. Starr A, Hamilton AE: Correlations between confirmed sites of neurological lesions and abnormalities of far field auditory brainstem responses . Electroencephalogr Clin Neurophysiol 1976;41:594-608.Crossref 13. Hashimoto I, Ishiyama Y, Yoshimoto T, et al: Brain-stem auditory evoked potentials recorded directly from human brain-stem and thalamus . Brain 1981;104:841-859.Crossref 14. Allison T, Goff WR, Williamson D, et al: On the neural origin of early components of the human somatosensory evoked potentials , in Desmedt JE (ed): Clinical Uses of Cerebral Brainstem and Spinal Somatosensory Evoked Potentials . New York, S Karger AG, 1981, pp 51-68. 15. Teasdale G, Jennet B: Assessment and prognosis of coma after head injury . Acta Neurochir 1976;34:45-55.Crossref 16. Kooi KA: Fundamentals of Electroencephalography . Hagerstown, Md, Harper & Row Publishers Inc, 1971. 17. Hume AL, Cant BR, Shaw NA: Central somatosensory conduction time in comatose patients . Ann Neurol 1979;5:379-384.Crossref 18. Hume AL, Cant BR: Central somatosensory conduction after head injury . Ann Neurol 1981;10:411-419.Crossref 19. Kaga K, Takigucki T, Myokai K, et al: Effect of deep hypothermia and circulatory arrest on the auditory brain stem responses . Arch Otorhinolaryngol 1979;225:199-205.Crossref 20. Stockard JJ, Sharbrough FW, Tinker JA: Effects of hypothermia on the human brainstem auditory response . Ann Neurol 1978;3:368-370.Crossref 21. Guerit J, Meulders M: Clinical application of the quantification of the relationship between body temperature and brain stem auditory evoked potentials. Read before the Tenth International Congress of Electroencephalography and Clinical Neurophysiology, Kyoto, Japan, Sept 14, 1981. 22. Stejskal L, Travnicek K, Sonrek K, et al: Somatosensory evoked potentials in deep hypothermia . Appl Neurophysiol 1980;43:1-7. 23. Hecox K, Cone B, Blaw M: Brainstem auditory evoked response in the diagnosis of pediatric neurologic diseases . Neurology 1981;31:832-840.Crossref 24. Seales DM, Torkelson RD, Shuman RM, et al: Abnormal brainstem auditory evoked potentials and neuropathology in 'locked in syndrome.' Neurology 1981;31:893-896.Crossref 25. Lindsay KW, Carlin J, Kennedy I, et al: Evoked potentials in severe head injury: Analysis and relation to outcome . J Neurol Neurosurg Psychiatry 1981;44:796-802.Crossref 26. Miltner FD, Haves E, Bushe KA: Prognostic aspects of electroclinical and neuroendocrine data in severe brain injury . Acta Neurochir Suppl 1979;28:43-49. 27. Trojaborg W, Jorgenson ED: Evoked cortical potentials in patients with 'isoelectric' EEG's . Electroencephalogr Clin Neurophysiol 1973;35: 301-309.Crossref 28. Starr A: Auditory brainstem responses in brain death . Brain 1976;99:543-554.Crossref 29. Prichard JW: Barbiturates: Physiological effects , in Glaser GH, Penry JK, Woodbury DM (eds): Antiepileptic Drugs . New York, Raven Press, 1980, pp 505-522. 30. Stockard JJ, Rossiter VS: Clinical and pathological correlates of brainstem auditory response abnormalities . Neurology 1977;27: 316-325.Crossref 31. Seales DM, Rossiter VS, Weinstein ME, et al: Brainstem auditory evoked responses in patients comatose as a result of blunt head injury . J Trauma 1971;19:347-353.Crossref 32. Benezech J, Rerebeau P, Privat JM, et al: Apport des potentiels évoqués du tronc cérébral (PET) pour l'étude clinique et le prognostic des comas traumatiques . Neurochirurgie 1979;25: 219-223. 33. Allen A, Starr A: Auditory brainstem potentials in monkey and man . Electroencephalogr Clin Neurophysiol 1978;45:53-63.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: May 1, 1983

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