Recommendations for the use of electroencephalography and evoked potentials in comatose patients

André‐Obadia, Nathalie; Zyss, Julie; Gavaret, Martine; Lefaucheur, Jean‐Pascal; Azabou, Éric; Boulogne, Sébastien; Guérit, Jean‐Michel; McGonigal, Aileen; Merle, P; Mutschler, Véronique; Naccache, Lionel; Sabourdy, Cécile; Trébuchon, Agnès; Tyvaert, Louise; Vercueil, Laurent; Rohaut, Benjamin; Delval, Arnaud

doi:10.1016/j.neucli.2018.05.038

Cited by 88 publications

(96 citation statements)

References 140 publications

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“…Instead of using the MMN feature occurring in the range 150-300ms, we used here the cumulative oscillation of the ERP (∆V relation 8) in the range of 20-500ms after stimulation. This analysis of the evoked response integrates various individual amplitude responses such as N20 to P300, which result from reverberation of neuronal networks activity in the frontal and auditory cortex [1]. In particular, the persistent presence of the P300 wave and large fluctuations of coherent response reflects a coherent brain activity.…”

Section: Integrative Value Of the New Featuresmentioning

confidence: 99%

“…It is a multimodal evaluation combining a clinical evaluation (Glasgow Scale, photomotor and pupillary reflexes) and electrophysiology, an evaluation of biological markers that can complete this series of examinations (NSE and S100b proteins to determine neuronal necrosis). Post-anoxic encephalopathy and its prognosis is also evaluated by electroencephalogram (EEG) [1]: the absence of a N20 response to somatosensory evoked potentials after stimulation of the median nerve has a specificity almost equal to 100% to predict the absence of awakening in the adult. However, the lack of response in intensive care unit (ICU) patients is difficult to assert due to the electrical environment that generates many artifacts that sometimes make it extremely difficult to interpret the low amplitude response of the evoked potential.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, standard sounds differ from deviant sounds in their intensity and frequencies. The study of MMN is performed by averaging responses to different stimuli to reduce the impact of brain activity independent of the stimulus [4,2,1]. However, the analysis and recognition of the presence or absence of MMN is difficult in intensive care patients, as many artifacts and a drastic reduction in the amplitude of evoked potentials make them difficult to isolate.…”

Section: Introductionmentioning

confidence: 99%

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Predictive analysis of patient recovery from cardiac-respiratory arrest

Floyrac¹,

Doumergue²,

Kubis

et al. 2019

Preprint

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The severity of neuronal damages in comatose patients following anoxic brain injury can be probed by evoked auditory responses. However, it remains challenging to predict the return to full consciousness of post-anoxic coma of hospitalized patients. We presented here a method to predict the return to consciousness based on the analysis of periodic responses to auditory stimulations, recorded from surface cranial electrodes. The input data are event-related potentials (ERPs), recorded non-invasively with electro-encephalography (EEG). We extracted several novel features from the time series responses in a window of few hundreds of milliseconds from deviant and non-deviant auditory stimulations. We use these features to construct two-dimensional statistical maps, that show two separated clusters for recovered (conscience) and deceased patients, leading to a high classification success as tested by a cross-validation procedure. Finally, using Gaussian, K-neighborhood and SVM classifiers, we construct probabilistic maps to predict the outcome of post-anoxic coma. To conclude, statistics of deviant and non-deviant responses considered separately provide complementary and confirmatory predictions for the outcome of anoxic coma.

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Section: Integrative Value Of the New Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Predictive analysis of patient recovery from cardiac-respiratory arrest

Floyrac¹,

Doumergue²,

Kubis

et al. 2019

Preprint

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“…Evoked potentials may be also useful for detecting a brainstem lesion. EEG [11] may be supportive in patients with abnormal movements and disorders of consciousness, and cerebrospinal fluid (CSF) analysis for those with suspected inflammatory or infectious diseases.…”

Section: Brainstem Motor and Sensory Deficits And Cranial Nerve Palsymentioning

confidence: 99%

“…Somatosensory evoked potentials (SSEP) assess conduction from peripheral nerves (N9) to the somatosensory cortical (N20) regions passing through the brainstem (P14). Brainstem auditory evoked potentials (BAEP) are described in Table 6 [11]. Interestingly, sedation increases latencies and decreases amplitudes of evoked potentials in a dose-dependent manner but does probably [31].…”

Section: Impairment Of Consciousnessmentioning

confidence: 99%

Brainstem dysfunction in critically ill patients

et al. 2020

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The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, impairment of consciousness, dysautonomia, and respiratory failure. The brainstem is prone to various primary and secondary insults, resulting in acute or chronic dysfunction. Of particular importance for characterizing brainstem dysfunction and identifying the underlying etiology are a detailed clinical examination, MRI, neurophysiologic tests such as brainstem auditory evoked potentials, and an analysis of the cerebrospinal fluid. Detection of brainstem dysfunction is challenging but of utmost importance in comatose and deeply sedated patients both to guide therapy and to support outcome prediction. In the present review, we summarize the neuroanatomy, clinical syndromes, and diagnostic techniques of critical illness-associated brainstem dysfunction for the critical care setting.

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Neuro-Prognostication After Cardiopulmonary Resuscitation

Wang

2020

Sudden Death

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Recommendations for the use of electroencephalography and evoked potentials in comatose patients

Cited by 88 publications

References 140 publications

Predictive analysis of patient recovery from cardiac-respiratory arrest

Predictive analysis of patient recovery from cardiac-respiratory arrest

Brainstem dysfunction in critically ill patients

Neuro-Prognostication After Cardiopulmonary Resuscitation

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