Brainstem Auditory Evoked Potentials in Respiratory Insufficiency Following Encephalitis

Schwarz, Gerhard; Litscher, Gerhard; Rumpl, E.; Pfurtscheller, Gert; Reimann, R

doi:10.3109/00207459608987248

Cited by 12 publications

(4 citation statements)

References 35 publications

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“…Critically ill patients are at risk of brain dysfunction induced not only by primary brain insults but also by neuroinflammation [ 95 ], ischemia secondary to microcirculatory dysfunction, and the neurotoxic effect of metabolic disturbance leading to impaired membrane excitability, neural conduction, and neural loss [ 96 – 98 ]. Impaired central auditory [ 99 – 102 ] and somatosensory [ 103 – 105 ] pathways have been documented by studies of evoked potentials to be associated with increased mortality in patients with impaired consciousness. Studies investigating the prognostic value of laser-evoked potentials and their correlation with EEG-R may be useful [ 106 ].…”

Section: Discussionmentioning

confidence: 99%

Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: a systematic review

et al. 2018

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BackgroundElectroencephalography (EEG) is a well-established tool for assessing brain function that is available at the bedside in the intensive care unit (ICU). This review aims to discuss the relevance of electroencephalographic reactivity (EEG-R) in patients with impaired consciousness and to describe the neurophysiological mechanisms involved.MethodsWe conducted a systematic search of the term “EEG reactivity and coma” using the PubMed database. The search encompassed articles published from inception to March 2018 and produced 202 articles, of which 42 were deemed relevant, assessing the importance of EEG-R in relationship to outcomes in patients with impaired consciousness, and were therefore included in this review.ResultsAlthough definitions, characteristics and methods used to assess EEG-R are heterogeneous, several studies underline that a lack of EEG-R is associated with mortality and unfavorable outcome in patients with impaired consciousness. However, preserved EEG-R is linked to better odds of survival. Exploring EEG-R to nociceptive, auditory, and visual stimuli enables a noninvasive trimodal functional assessment of peripheral and central sensory ascending pathways that project to the brainstem, the thalamus and the cerebral cortex. A lack of EEG-R in patients with impaired consciousness may result from altered modulation of thalamocortical loop activity by afferent sensory input due to neural impairment. Assessing EEG-R is a valuable tool for the diagnosis and outcome prediction of severe brain dysfunction in critically ill patients.ConclusionsThis review emphasizes that whatever the etiology, patients with impaired consciousness featuring a reactive electroencephalogram are more likely to have a favorable outcome, whereas those with a nonreactive electroencephalogram are prone to having an unfavorable outcome. EEG-R is therefore a valuable prognostic parameter and warrants a rigorous assessment. However, current assessment methods are heterogeneous, and no consensus exists. Standardization of stimulation and interpretation methods is needed.

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Section: Discussionmentioning

confidence: 99%

Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: a systematic review

et al. 2018

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“…These data show that the study of the BAEPs is useful in evaluating the damage produced by anoxia (Benna et al, 1985). Schwarz et al, 1996 showed prolonged interpeak latencies (I-III, I-V, III-V, IV-V) and delayed absolute latencies of waves II, III, V, and I, at least on one side, in the BAEP. The auditory pathways are near the respiratory control centers in the brain stem; therefore, the electrophysiologic abnormalities of wave III and the IV-V complex may be a reflection of the disturbed central control of ventilation.…”

Section: Brainstem Strokementioning

confidence: 99%

Visual and Brainstem Auditory Evoked Potentials in Neurology

Zaher¹

2012

EMG Methods for Evaluating Muscle and Nerve Function

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“…Abnormalities consisting of prolongation of waves and increased interpeak latency intervals have been reported in a number of mental retardation syndromes [7] patients with head trauma [8], and hydrocephalus [9]. However, there have been some documented effects of sedation on the interpeak latency intervals of the ABR in children with mental retardation [10], in other neurologic disorders such as central alveolar hypoventilation [11,12] as well as in patients with respiratory insufficiency following encephalitis [13]. Due to the documented effects of sedation on estimates of interpeak latency intervals in some clinical populations, it has been suggested that abnormal interpeak latency intervals reported in patient populations such as fragile × syndrome may be related to the use of sedation as opposed to inherent features of the disorder [10].…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that the unstable respiratory control in the awake state in Rett Syndrome is indicative of immature brain stem function [29] or poor control over brainstem respiratory centers during the wake period [33]. Because the generators for the ABR are in close proximity to the centers for regulation of respiration in the brainstem, it would not be surprising for ABR abnormalities to occur in Rett Syndrome as in some patients with disturbed central control of respiration[13]. In addition, mutations in MeCP2 are associated with a wide range of neurological phenotypes and patients with the mutations typically have deficits in autonomic processes that are regulated at brainstem levels [34].…”

Section: Introductionmentioning

confidence: 99%

Effects of Sedation on Auditory Brainstem Response in Rett Syndrome

Pillion

Bibat

Naidu

2010

Pediatric Neurology

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Prolongation of the I-V interpeak latency intervals have been reported in Rett Syndrome and other neurodevelopmental disorders. It has been suggested that the use of sedation may account for differences in the interpeak latency intervals when comparisons are made across diagnostic groups if sedated control groups are not used for the basis of comparison. This study examined the effects of sedation on Auditory Brainstem Response interpeak latency intervals (i.e., I-III, III-V and I-V) in two groups of individuals: 1) a group with Rett Syndrome who were positive for mutations in the MeCP2 gene, and 2) a group negative for mutations in the MeCP2 gene but who were severe to profoundly delayed with other causes of mental retardation. A third group of sedated and unsedated female participants taken from our normative ABR data base was also included in order to further assess the effects of sedation. An analysis of variance indicated, 1) longer I-V interpeak latency intervals in the sedated participants with Rett Syndrome; 2) longer III-V interpeak latency intervals in the mutation positive participants as compared to non-Rett Syndrome mutation negative participants and 3) t-tests revealed no significant effects of sedation on the I-III, III-V or I-V interpeak latency intervals among the normative group participants. Our findings suggest a possible biological basis for the discrepancy in the literature on auditory brain stem responses in Rett Syndrome, and warrant cautious interpretation of auditory brain stem responses findings in sedated subjects with Rett Syndrome as well as in those with mental retardation and seizures.

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Brainstem Auditory Evoked Potentials in Respiratory Insufficiency Following Encephalitis

Cited by 12 publications

References 35 publications

Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: a systematic review

Value and mechanisms of EEG reactivity in the prognosis of patients with impaired consciousness: a systematic review

Visual and Brainstem Auditory Evoked Potentials in Neurology

Effects of Sedation on Auditory Brainstem Response in Rett Syndrome

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