The assessment of severe head injury by short-latency somatosensory and brain-stem auditory evoked potentials

Cant, B.R; Hume, Ann L.; Judson, James A.; Shaw, N.A.

doi:10.1016/0168-5597(86)90053-5

Cited by 133 publications

(27 citation statements)

References 24 publications

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“…32 The use of other promising electrophysiological techniques, including continuous EEG monitoring and serial sensory evoked response testing, should also be assessed. 33 " 35 …”

Section: Le Journal Canadien Des Sciences Neurologiquesmentioning

confidence: 99%

An Electroencephalographic Classification for Coma

Young

McLachlan

Kreeft

et al. 1997

Can. J. Neurol. Sci

126

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Background:The assessment of thalamocortical function in comatose patients in the intensive care unit (ICU) can be difficult to determine. Since the electroencephalogram (EEG) affords such assessment, we have developed an EEG classification for comatose patients in our general ICU. Methods: One hundred EEGs were classified in a blinded fashion by two EEGers, using our method and that of Synek. Interobserver agreement was assessed using kappa score determination. Results: Kappa scores were 0.90 for our system and 0.75 for the Synek system. (The Kappa score represents the inter-rater agreement that is beyond chance; 0.90 is almost perfect agreement, while 0.75 is substantial agreement). Conclusion: Our system for classifying EEGs in comatose patients has a higher interobserver reliability than one that was previously published. This EEG classification scheme should be useful in clinical electrophysiological research involving ICU patients, allowing for internal consistency and comparisons among centres. RESUME: Une classification electroencephalographique du coma. Introduction: II peut etre difficile d'eValuer la fonction thalamocorticale chez les patients comateux a l'unite de soins intensifs (USI). Comme cette evaluation peut etre faite au moyen de l'electroencephalogramme, nous avons developpe une classification EEG pour les patients comateux a notre USI generale. Methodes: Deux electeoencephalographistes ont classify cent EEGs a l'aveugle, en utilisant notre methode et celle de Synek. La concordance interobservateur a et6 evaluee au moyen de la cote kappa. Resultats: Les cotes kappa etaient de 0.90 pour notre systeme et de 0.75 pour le systeme Synek. (La cote kappa represente la concordance interobservateur au-dela de la chance; 0.90 est une concordance presque parfaite, alors que 0.75 est une bonne concordance). Conclusion: Notre systeme de classification des EEGs chez les patients comateux a une plus grande fiabilite interobservateur qu'une autre classification deja publi6e. Cette methode de classification EEG devrait etre utile en recherche clinique electrophysiologique chez des patients de l'USI, en tenant compte de la concordance interne et de la comparaison intercentres.Can. J. Neurol. Sci. 1997; 24: 320-325 Neurological disease in the setting of the intensive care unit (ICU) has a variable prognosis from full recovery to death. More than 10% of patients in general ICUs suffer serious central nervous system complications that add to their morbidity and mortality.1 Assessment of illness severity is an important component of the management of such cases. There are a number of standardized assessment scales for measuring the severity of illness, which is related to outcome: APACHE (Acute Physiology and Chronic Health Evaluation), APACHE II or APACHE III, the Sepsis Severity Score, Simplified Acute Physiology Score II (SAPS II) and the Mortality Prediction Model (MPM) 2 "6 The APACHE scales use the Glasgow Coma Scale as part of the acute physiology evaluation while other scales incorporate clini...

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“…32 The use of other promising electrophysiological techniques, including continuous EEG monitoring and serial sensory evoked response testing, should also be assessed. 33 " 35 …”

Section: Le Journal Canadien Des Sciences Neurologiquesmentioning

confidence: 99%

An Electroencephalographic Classification for Coma

Young

McLachlan

Kreeft

et al. 1997

Can. J. Neurol. Sci

126

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“…Auditory evoked potentials have been widely studied in patients with severe traumatic brain injury [4,5,6]. Most studies reveal short latency potentials reflecting brain stem activity, but few studies exist on long latency auditory-evoked potentials (LLAEPs), either in the acute phase [7,8], or in the long term [9,10].…”

Section: (Text)mentioning

confidence: 99%

Correlations between neuropsychological test results and P300 latency during silent-count and button-press tasks in post-traumatic brain injury patients

Reza

Ikoma

Chuma

et al. 2006

Journal of Clinical Neuroscience

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Abstract:To evaluate the correlations between memory function and intelligence and event-related potential, the P300 component for different tasks was studied for 30 post-traumatic brain injury patients (mean age 31.6 ± 13.7 years; 23 male and 7 female). Memory function, intelligence, and depression were measured by using the Mini-Mental State Examination, the revised Wechsler Adult Intelligence Scale and the Self-Rating Depression Scale, respectively. P300 latency was measured during silent-count and button-press tests at three midline scalp (Fz, Cz, and Pz) sites for all subjects by using an auditory 'odd-ball' paradigm. Neuropsychological memory score was predicted by intelligence score, but neurophysiological P300 latency was predicted by memory score for the silent-count test and by intelligence score for the button-press test. These results show that the P300 event-related potential component is sensitive to the diverse nature of cognitive deficits in post-traumatic brain injury patients during different types of discrimination tasks.However, future research is necessary to replicate and extend these findings.

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“…Because all patients were pharmacologically paralyzed, it was not possible to use the twitch of the abductor pollicis brevis to gauge the adequacy of the stimulus. The presence of the P 15 wave was used for this purpose. SSEPs were recorded from the contralateral C 3 ' and C 4 ' (central) electrodes referenced to linked ears.…”

Section: Ssep Monitoringmentioning

confidence: 99%

“…SSEP monitoring was generally begun shortly after admission to the ICU and repeat clinical examination of the patient if the GCS remained below 8. Monitoring was discontinued after 5-6 days if ICP was stable and showed no increasing trends, later if ICP remained elevated, and sooner if the patient had evidence of electrical brain and brainstem silence with a consistent clinical examination (e.g., the development of an isoelectric EEG or of a P 15 wave only on SSEP traces with the evolution of bilaterally fixed and dilated pupils).…”

Section: Ssep Monitoringmentioning

confidence: 99%

Somatosensory Evoked Potentials and Intracranial Pressure in Severe Head Injury

Konasiewicz

Moulton

Shedden

1994

Can. j. neurol. sci.

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The purpose of this study was to explore the relationship between neurologic function, using a quantitative measurement of continuous somatosensory evoked potentials (SSEPs), and intracranial pressure (ICP) following traumatic brain injury. During a 6 year period, severely headinjured patients with a Glascow Coma Scale < 8 who were not moribund were monitored with SSEPs and ICP measurements. SSEPs from each hemisphere and ICP were recorded hourly for each patient. Neurologic outcomes were scored using the Glasgow Outcome Scale at three months post injury. Although initial SSEP amplitude did not correlate well with outcome, final SSEP summed peak to peak amplitude from both hemispheres (p = .0001), the best hemisphere (p = .0004), and the worst hemisphere (p = .0001) correlated well with the Glasgow Outcome Scale groups. Of a total of 72 patients, 40 had deteriorating SSEPs and 32 had stable or improving SSEPs. Peak ICP values were not statistically different in these groups (p = .6). Among patients with deteriorating SSEPs, 52.5% lost the greatest proportion of hemispheric electrical activity prior to ICP elevation. In the remaining patients, the percent reduction of SSEP activity after peak ICP levels was not statistically different from the percent reduction in SSEP activity prior to the peak ICP levels (p = .9). This data suggests that in a select group of patients with severe head injury, ICP does not cause SSEP deterioration, but rather is the consequence of deterioration of brain function.Resume: Potentiels evoques somesthesiques et pression intracranienne dans les traumatismes craniens severes. Le but de cette etude etait d'explorer, au moyen d'une mesure quantitative des potentiels eVoqufis somesthesiques (PESs) continus, la relation entre la fonction neurologique et la pression intracranienne suite a un traumatisme cranien.

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The assessment of severe head injury by short-latency somatosensory and brain-stem auditory evoked potentials

Cited by 133 publications

References 24 publications

An Electroencephalographic Classification for Coma

An Electroencephalographic Classification for Coma

Correlations between neuropsychological test results and P300 latency during silent-count and button-press tasks in post-traumatic brain injury patients

Somatosensory Evoked Potentials and Intracranial Pressure in Severe Head Injury

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