title: Re-evaluation of short latency somatosensory evoked potentials (P13, P14 and N18) for brainstem function in children who once suffered from deep coma.
abstract: One of the major clinical features of brain death is deep coma. Therefore, we re-evaluated retrospectively electrophysiological examinations of brainstem function in about 31 children who had once suffered from deep coma in order to reveal its pathophysiological characteristics. The patient age at coma ranged from 1 month to 10 years (mean 2 years 1 month). The electrophysiological examinations were performed, including any of short-latency somatosensory evoked potential (SSEP), brainstem auditory evoked potential (BAEP) and blink reflexes. We first compared results between the fair and poor prognostic groups, and then re-evaluated SSEP results on a few severely impaired patients with persistent vegetative state (PVS). Subsequently, SSEP clarified more specific findings for a deep coma condition than BAEP and blink reflex. A lack of P14, N18 and N20, and an amplitude reduction or vagueness of P13 in SSEP in these children strongly suggested high risk in their future neurological prognosis. In conclusion, electrophysiological examinations, especially SSEP (P13, P14 and N18), might be very useful in obtaining a long-term neurological prognosis after deep coma in children.
authors.affiliation: Department of Pathological Science and Technology, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan. tomita@grape.med.tottori-u.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tomita
authors.forename: Chisako
authors.initials: C
authors.lastname: Fukuda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Maegaki
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hanaki
authors.forename: Kahoru
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Mari
authors.initials: M
authors.lastname: Sanpei
mesh_terms: D001767:Blinking / Q000502:physiology; D001926:Brain Death; D001933:Brain Stem / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000503:physiopathology*; D004558:Electric Stimulation; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods; D005069:Evaluation Studies as Topic; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018458:Persistent Vegetative State / Q000503:physiopathology; D011930:Reaction Time; D012189:Retrospective Studies