Cortical evoked responses after TBI in adults and developmental age

Research output: Contribution to journalArticle

Abstract

In the acute phase, SEPs are powerful predictors of outcome, particularly poor outcome, if patients with focal lesion, subdural effusion, and those who have had recent decompressive craniotomies are excluded (Carter et Butt 2001; Beca et al., 1995). SEPs cannot substitute for the clinical examination but might be a useful tool for the intensivists to assess the patient's potential for recovery. Beca et al. (1995) suggest that SEPs be performed in all children with acute, severe brain injury, because they are the best predictors of outcome in this group. SEPs are excellent predictors of long-term outcome (5 years) following severe brain injury in children, too (Carter et al., 1999). Moreover, this objective measure of neurological function can play an important role in identifying patients who require further intensive rehabilitation (Mazzini et al., 1999) and allows assessment of the effectiveness of treatment options and rehabilitation plans (Rappaport et al., 1977). According to several authors, auditory and visual evoked potentials are poor predictors of outcome (Stanca et al., 1990; Rapport et al., 1977; Pfurtscheller et al., 1985) and do not add further prognostic information to SEPs. Others found that long-latency cortical auditory and visual evoked responses were significantly correlated with clinical disability. Blancafort et al.'s (1995) study found that, when performed early in children in post-traumatic coma due to diffuse brain injury, BAEPs have a predictive value in that they allow a very accurate prognosis in patients with lesions that evade clear radiological visualization. Certainly, BAEP and VEP do not so much have a prognostic value as a diagnostic value as they reveal the functional damage and thus may help select the correct communication channel. Cognitive functions do not appear to be related to short-latency MEP results (Özbudak-Demir et al., 1999; Shin et al., 1989), but persistent abnormalities in long-latency responses tend to reflect the extent of cognitive impairments and reduced psychometric scores. Unfortunately, absolute values cannot be relied upon as prognosticators due to the variability of long-latency responses, even in controls (Kane et al., 1996). Ruijs et al.'s study (1993) found that, when measured in conscious patients including children with closed head trauma, the latency time of the P300 somatosensory evoked potential provides a specific clue to long-term residual symptoms in school performance and behavior.

Original languageEnglish
Pages (from-to)33-40
Number of pages8
JournalSAGGI - Child Development and Disabilities
Volume29
Issue number2
Publication statusPublished - 2003

Keywords

  • Auditory/visual evoked potentials
  • Coma
  • Motor evoked potentials
  • Somatosensory evoked potentials
  • Traumatic brain iniury

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Rehabilitation
  • Neuropsychology and Physiological Psychology

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