Predictive value of electrophysiology in children with hypoxic coma.
Assessment of prognosis of children in hypoxic coma is difficult. The value of clinical evaluation is often limited. The usefulness of electrophysiologic tests has been documented mostly in adults and neonates and in cases of traumatic coma. We reviewed retrospectively 39 consecutive children with nontraumatic hypoxic coma to assess the prognostic value of EEG, visual, and auditory evoked potentials. Correlation between electrophysiology and neurologic outcome after mean follow-up period of 30 months was significant (r(s) = 0.6, P < 0.001). In contrast there was no correlation between Pediatric Risk of Mortality score (PRISM) and outcome (r(s) = -0.42, P = 0.8). Combining magnetic resonance imaging with electrophysiology further enhanced their prognostic value (r(s) = 0.69, P < 0.001). Neuroimaging was highly sensitive but less specific, and electrophysiologic tests were highly specific but less sensitive. We conclude that early electrophysiology can contribute to predicting outcome in pediatric hypoxic coma.
Mewasingh
Leena D
LD
Department of Neurology, Children's University Hospital Queen Fabiola, Brussels, Belgium
Christophe
Catherine
C
Fonteyne
Christine
C
Dachy
Bernard
B
Ziereisen
France
F
Christiaens
Florence
F
Deltenre
Paul
P
De Maertelaer
Viviane
V
Dan
Bernard
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis* / Q000503:physiopathology; D004569:Electroencephalography / Q000379:methods; D004594:Electrophysiology; D005072:Evoked Potentials, Auditory / Q000502:physiology; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000503:physiopathology; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018709:Statistics, Nonparametric