EEG reactivity in the prognosis of severe head injury

Abstract

We compared reactivity of EEG to external stimuli--an easily and quickly available measure--with the central conduction time (CCT) of the somatosensory evoked potentials, currently the most-used electrophysiologic method to predict outcome in severe head injury (SHI), and with the initial Glasgow Coma Scale (GCS) score. In 50 patients, comatose subsequent to SHI, we measured EEG reactivity and CCT within 48 to 72 hours and compared them with the outcome after 1.5 years. Using discriminant analysis, EEG reactivity correctly classified 92%, CCT classified 82%, and both measures together classified 98% of the patients into globally good or bad outcome groups. GCS allowed a correct classification in only 72% and, combined with either of the two electrophysiologic measures, did not further increase predictability. EEG reactivity is an excellent long-term global outcome predictor in SHI, superior to CCT and GCS. When the two electrophysiologic measures are combined, a prognostic accuracy is achieved that is better than that of any other reported method.

Automated Analysis of Background EEG and Reactivity During Therapeutic Hypothermia in Comatose Patients After Cardiac Arrest

“…Lack of reactivity is related to poor neurologic recovery 4,5 . In patients with postanoxic coma, nonreactive EEG background activity during or after TH is an early predictor of poor outcome 2,6 .…”

EEG predictors of outcome in patients with disorders of consciousness admitted for intensive rehabilitation

“…EEG reactivity was evaluated by a forced eye opening (15 s) repeated 3 times at intervals of approximately 5 min. Reactivity was considered present when changes in the frequency (increase or slowing) or amplitude (increase or reduction) were detected during opening of the eyes in at least one of the trials (Gütling et al, 1995;Logi et al, 2011). If no changes were detected in any of the three trials, then reactivity was considered absent.…”

Brain response to thermal stimulation predicts outcome of patients with chronic disorders of consciousness

“…EEG-R after external stimuli represents the neural activity along the afferent somatosensory pathways through the ascending reticular activating system to the cortex. Thus, the presence of EEG-R has been taken as an important measure for predicting of outcome of patients with disorders of consciousness (Gutling et al, 1995;Rossetti et al, 2010;Thenayan et al, 2010;Logi et al, 2011). However, EEG-R tests conducted in prior work were often performed with nociceptive stimulations.…”