How reliable is the predictive value of SEP (somatosensory evoked potentials) patterns in severe brain damage with special regard to the bilateral loss of cortical responses?

Abstract

SEP allow an early reliable assessment of both poor and good prognosis in SBD, in particular when applied serially. BLCR does not always imply a fatal diagnosis, as a circumscribed contusional lesion rarely may lead to selective reversible blockage of ascending somatosensory pathways in the brainstem. In contradiction to this lesional etiology, a hypoxia-induced BLCR pattern seems to correlate strictly with a poor prognosis, reflecting a different pathogenesis with diffuse destruction of cortex and thalamocortical pathways.

Early Prediction of Neurological Outcome after Cardiopulmonary Resuscitation: A Multimodal Approach Combining Neurobiochemical and Electrophysiological Investigations May Provide High Prognostic Certainty in Patients after Cardiac Arrest

“…We found SEPs with BLCR only in patients with very poor outcome (persistent vegetative state at best). This agrees with several previous studies [3, 4, 5, 20, 21, 22, 23, 24, 25]. Amplitude configuration abnormalities and prolonged central conduction time were less predictive; the percentage of occurrence was similar in both outcome groups.…”

Severe brain injury in children: long-term outcome and its prediction using somatosensory evoked potentials (SEPs)

“…They have been shown to be more powerful than electroencephalograms [24, 36±39] and are superior to clinical signs and measures such as cranial nerve and motor responses [36,40,41], and the Glasgow Coma Score [18,21,42,43]. They can also be performed in clinical situations that prevent the performance of these other tests.…”

Koma

“…dieses ca. 3 Monate oder 6 Monate [21] nach dem Unfall ermittelten. Einen ähn-lich langen Zeitraum wählten u. a. Cant et al [6].…”