Predictive value of somatosensory evoked potentials for awakening from coma*

Robinson, Lawrence R.; Micklesen, Paula J.; Tirschwell, David; Lew, Henry L.

doi:10.1097/01.ccm.0000053643.21751.3b

Cited by 218 publications

(112 citation statements)

References 64 publications

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“…When bilaterally absent or alternatively normal following TBI, SSEPs may help detect patients with poor or good prognosis [121]. For example, normal SSEPs (grade 1) after TBI are associated with a 57% chance of good recovery, whereas bilaterally absent SSEPs (grade 6) are associated with only a 1% chance of functional recovery [122]. Unfortunately, intermediate test results are less helpful.…”

Section: Ssep In Traumatic Brain Injurymentioning

confidence: 99%

Section: Ssep In Hypoxic-ischemic Encephalopathymentioning

confidence: 99%

“…Among 1136 patients with hypoxic-ischemic encephalopathy after cardiac arrest, absent SSEPs were associated with no patients awakening from coma [122], particularly when combined with absent EEG reactivity [131], although withdrawal of care may have biased such results. Normal SSEPs had less predictive capacity; in the same cohort, only 52% of patients with normal SSEPs awakened from coma [122]. The ability of absent SSEPs to detect patients at risk for poor neurological outcome appear to be robust even among patients undergoing therapeutic hypothermia following arrest [132], although withdrawal of care may bias this and other retrospective experiences.…”

Section: Ssep In Hypoxic-ischemic Encephalopathymentioning

confidence: 99%

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The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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Neuromonitoring is an emerging field that aims to characterize real-time neurophysiology to tailor therapy for acute injuries of the central nervous system. While cardiac telemetry has been used for decades among patients requiring critical care of all kinds, neurophysiology and neurotelemetry has only recently emerged as a routine screening tool in comatose patients. The increasing utilization of electroencephalography in comatose patients is primarily due to the recognition of the common occurrence of nonconvulsive seizures among comatose patients, the development of quantitative measures to detect regional ischemia, and the appreciation of electroencephalography phenotypes that indicate prognosis after cardiac arrest. Other neuromonitoring tools, such as somatosensory evoked potentials have a complementary role, surveying the integrity of the neuroaxis as an indicator of prognosis or illness progression in both acute brain and spinal injuries.

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Section: Ssep In Traumatic Brain Injurymentioning

confidence: 99%

Section: Ssep In Hypoxic-ischemic Encephalopathymentioning

confidence: 99%

Section: Ssep In Hypoxic-ischemic Encephalopathymentioning

confidence: 99%

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The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Rosenthal

2012

Neurotherapeutics

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“…The median nerve somatosensory evoked potentials (SEPs) have been reported to accurately predict poor outcome after cardiac arrest (3,4). Hypothermia is known to prolong all neuronal conduction velocities, including the SEP and brainstem auditory evoked potential (BAEP) latencies, and temperature has also been reported to affect the amplitudes of SEP responses (5)(6)(7)(8).…”

mentioning

confidence: 99%

Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia*

Tiainen

Kovala

Takkunen

et al. 2005

Critical Care Medicine

173

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“…On the other hand, somatosensory evoked potentials (SEP) (visual, auditory, sensory) altering baseline EEG may be involved in central nervous system integrity assessment as they are relatively resistant to the impact of anesthetic drugs (32).…”

Section: Methods Reflecting Cerebral Global Functionmentioning

confidence: 99%

Multimodal neuromonitoring

Macas¹,

Bilskienė²,

Gembickij³

et al. 2012

AML

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The goal of the intensive care management of a neurosurgical patient is to preserve adequate cerebral perfusion, oxygenation and metabolism in order to prevent secondary neurological injury. In preventing secondary neurological insults interventions must be started early. For many years conventional methods of neuromonitoring have proved their efficacy. However, their sensitivity in detecting subtle metabolic derangements in the real time manner is low and the valuable time for the appropriate treatment is lost. In recent years, there are numerous study data suggesting that implying of advanced neuromonitoring techniques can improve outcomes. Moreover, it helps to guide goal-directed therapy. Although data on advanced neuromonitoring are preliminary and mostly observational, the number of modern neurosurgical centers applying it as a standard is high. With the increasing technical possibilities, the concept of multimodal neuromonitoring is of increasing popularity. Multimodal neuromonitoring allows continuous real time assessment of cerebral perfusion, oxygenation, metabolism and global function which makes it attractive and promising in clinical practice.

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Predictive value of somatosensory evoked potentials for awakening from coma*

Abstract: Somatosensory evoked potential results predict the likelihood of nonawakening from coma with a high level of certainty. Adults in coma from hypoxic-ischemic encephalopathy with absent somatosensory evoked potential responses have <1% chance of awakening.

Cited by 218 publications

References 64 publications

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

The Utility of EEG, SSEP, and Other Neurophysiologic Tools to Guide Neurocritical Care

Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia*

Multimodal neuromonitoring

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