The assessment of severe head injury by short-latency somatosensory and brain-stem auditory evoked potentials |
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| Affiliation: | 1. Department of Clinical Neurophysiology Auckland Hospital, Aukland 1 New Zealand;2. Department of Critical Care Medicine, Auckland Hospital, Aukland 1 New Zealand;1. Department of Human Sciences, The Ohio State University, Columbus, OH 43210, United States;2. Department of Kinesiology, University of North Carolina at Charlotte, Charlotte, NC 28223, United States;3. Exercise Physiology Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, United States;4. Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ 08618, United States;5. Athlete Health & Performance, Sports and Human Performance Diagnostics, Quest Diagnostics, Madison, NJ 07940, United States;6. Department of Kinesiology, University of Connecticut, Storrs, CT 06269, United States;7. Department of Health & Exercise Science, Appalachian State University, Boone, NC 28608, United States;1. Institute of Medical Equipment, National Biological Protection Engineering Centre, Tianjin, China;2. Department of Pharmacology, Logistics University of Chinese People’s Armed Police Forces, Tianjin, China;1. Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Kunming, Yunnan 650223, China;2. Department of Dermatology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China;3. Kunming College of Life Science, University of Chinese Academy of Sciences, Kunming, Yunnan 650204, China;1. Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain;2. National Advisory Unit for Prehospital Emergency Medicine (NAKOS) and Department of Anaesthesiology, Oslo University Hospital and University of Oslo, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway;3. Department of Electrical Engineering and Computer Science, Faculty of Science and Technology, University of Stavanger, 4036 Stavanger, Norway |
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| Abstract: | The relative prognostic value of short-latency somatosensory evoked potentials (SEPs) and brain-stem auditory evoked potentials (BAEPs) was assessed in 35 patients with post-traumatic coma. Analysis of the evoked potentials was restricted to those recorded within the first 4 days following head injury. Abnormal SEPs were defined as an increase in central somatosensory conduction time or an absence of the initial cortical potential following stimulation of either median nerve. Abnormal BAEPs were classified as an increase in the wave I–V interval or the loss of any or all of its 3 most stable components (waves I, III and V) following stimulation of either ear. SEPs reliably both good and bad outcomes. All 17 patients in whom SEPs were graded as normal had a favourable outcome and 15 of 18 patients in whom SEPs were abnormal had an unfavourable outcome. Although abnormal BAEPs were associated with an unfavourable outcome in almost all patients (6 of 7), only 19 of 28 patients with normal BAEPs had a favourable outcome. The finding of normal BAEPs was therefore of little prognostic significance. These results confirm the superiority and greater sensitivity of the SEP in detecting abnormalities of brain function shortly after severe head trauma. |
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