[Importance of evoked potentials in the evolutive prognosis of coma during cerebral anoxia in adults].
Ten cases of postanoxic coma have been studied. A clinical neurological examination with study of brainstem reflexes and the EEG recording were made on the first day (J1), the third day (J3) and the tenth day (J10) after the start of the coma. A recording of the visual evoked potentials, the brainstem evoked potentials and the somatosensory potentials combined was made at the same time. A clinical examination is carried out one month after the coma when the patient survives. According to the initial clinical examination, we distinguished 3 groups of subjects. The results show that in group III the visual evoked potentials such as EEG have a slightly significant prognostic value; frequently the near outcome lead to death whereas EEG activity persists and the visual evoked potentials disappear later. On the other hand, the association of brainstem evoked potentials and somatosensory potentials clearly has a higher prognostic value in this group. The disappearance of the shortest brainstem responses and the cortical somatosensory responses is clearly an unfavourable prognosis. This disappearance associated with the end EEG activity is the absolute proof of brain death. On the other hand, the persistence of these responses is of a better prognosis at least on the survival level, but their degradation during evolution is unfavourable.
Cheliout-Héraut
F
F
Service central d'explorations fonctionnelles, hôpital Raymond-Poincaré, Garches, France.
Durand
M C
MC
Clair
B
B
Gajdos
P
P
Raphaël
J C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D003128:Coma / Q000209:etiology / Q000503:physiopathology*; D004569:Electroencephalography; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Intérêt des potentiels évoqués dans le pronostic évolutif des comas par anoxie cérébrale chez l'adulte.