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Spatial mapping of SEP in comatose patients: Improved outcome prediction by combined parietal N20 and frontal N30 analysis
- Source :
- Brain Topography. 3:447-455
- Publication Year :
- 1991
- Publisher :
- Springer Science and Business Media LLC, 1991.
-
Abstract
- The aim of this study is to evaluate whether SEP spatial mapping can improve outcome prediction in comparison to the conventional SEP recordings. Twenty patients comatose as a result of head injury or cerebral vascular disorders were submitted to 19-channel SEP mapping from median nerve stimulation. SEP recording were performed within the 4th hospital day in 18 cases and over one month from the insult in the remaining two. Nine patients (45%) showed a good recovery or a mild disability, 3 (15%) a severe disability and the rest (40%) died or remained in a vegetative state. Five patients (28%) had bilaterally normal SEP, 5 (28%) the absence of both parietal N20 and frontal N30, while the others (44%) had a dissociation N20/N30 (namely, preserved N20 with absent N30). The SEP mapping was significantly related to the outcome (P = 0.0087) and improved the outcome prediction in comparison to the conventional SEP recordings, allowing to check the presence of frontal N30: in patients with bilaterally present N20 the outcome appeared to depend upon the N30. SEP mapping proved to be a far superior prognostic indicator than the Glasgow Coma Scale. In 3 patients with midline shift on CT scan an abnormal spatial distribution of N20 was disclosed by SEP mapping. Our preliminary results suggest that SEP mapping may improve the assessment of comatose patients in comparison to the use of parietal derivations only.
- Subjects :
- Adult
Male
medicine.medical_specialty
Neurology
Subarachnoid hemorrhage
Adolescent
behavioral disciplines and activities
Midline shift
Evoked Potentials, Somatosensory
Parietal Lobe
medicine
Craniocerebral Trauma
Humans
Radiology, Nuclear Medicine and imaging
Coma
Child
Electrodes
Stroke
Aged
Brain Mapping
Radiological and Ultrasound Technology
musculoskeletal, neural, and ocular physiology
Head injury
Glasgow Coma Scale
Middle Aged
Subarachnoid Hemorrhage
Prognosis
medicine.disease
Frontal Lobe
Cerebrovascular Disorders
Somatosensory evoked potential
Anesthesia
Female
Neurology (clinical)
Anatomy
medicine.symptom
Tomography, X-Ray Computed
Psychology
Subjects
Details
- ISSN :
- 15736792 and 08960267
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Brain Topography
- Accession number :
- edsair.doi.dedup.....c1d205fafc38e6e64cfc3fa6e35afe2e