Multimodality evoked potentials as a prognostic tool in term asphyxiated newborns.
Hypoxic-ischemic (HI) events may cause permanent brain damage, and it is difficult to predict the long-term neurological outcome of survivors. Multimodality evoked potentials (MEPs), using flash visual (fVEPs), somatosensory (SEPs), and brain-stem auditory evoked potentials (BAEPs) may assess the cerebral function in term neonates. MEPs were recorded in 40 hypoxic-ischemic term or near-term neonates during the first week of life in order to predict the neurological outcome. A 3 point grading system registered either mild, moderate, or severe abnormalities. At 24 months of corrected age, the infants were assessed with a blind protocol to determine neurological development. Grade 0 fVEPs and SEPs were associated with a normal neurological status with 100% (P < 0.001) of the infants. Abnormal SEPs or total grade (VEPs + SEPs) > I were not associated with normal outcomes (P < 0.0001). Normal BAEPs did not predict a normal outcome, but severely abnormal BAEPs did predict an abnormal outcome. A significant correlation was found between EP (VEPs + SEPs) grade (r = 0.9, P < 0.0001), Sarnat stage (r = 0.6, P < 0.001), and clinical outcome. This study confirmed that both fVEPs and SEPs are more accurate as prognostic indicators for term neonates. EPs (VEPs + SEPs) also are more accurate in predicting the ultimate neurological outcome compared with the Sarnat scoring.
Scalais
E
E
Department of Pediatrics, Pediatric Neurology, Entité Hospitalière, Centre Hospitalier Espérance St-Joseph, Liège, Belgium.
François-Adant
A
A
Nuttin
C
C
Bachy
A
A
Guérit
J M
JM
D001238:Asphyxia Neonatorum / Q000150:complications* / Q000503:physiopathology*; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000209:etiology; D005071:Evoked Potentials / Q000502:physiology*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005074:Evoked Potentials, Visual / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis