Bilateral loss of cortical somatosensory evoked potential at birth predicts cerebral palsy in term and near-term newborns.
Bilateral loss of cortical somatosensory evoked potential (SEP) is considered the single best indicator of adverse outcome in acute encephalopathy of adult patients and older children. This study determines whether the presence or absence of the neonatal cortical SEP can predict cerebral palsy at two years in survivors of neonatal encephalopathy scored according to Sarnat criteria. We also compare SEPs with visual evoked potentials (VEPs), the EEG and neonatal neurological status. Fifty-nine neonates admitted to the neonatal intensive care unit had SEP, VEP and EEG recordings analysed according to the presence (n=37, 63%) or absence (n=22, 37%) of neonatal encephalopathy (score >or=1). Cortical SEP was always present in the perinatal period in those surviving without major neurological disability, while it was bilaterally absent in all but one patient with a subsequent diagnosis of cerebral palsy. Multivariate analysis using the logistic regression model showed that bilateral loss of cortical SEP and Sarnat Score correctly classified the neurological outcome in all patients. Bilateral absence of cortical SEP indicates early identification of neonates at risk of cerebral palsy indicating that EPs have a clinical role in the workup of neonatal encephalopathy.
Suppiej
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A
Child Neurology and Clinical Neurophysiology Unit, Department of Paediatrics, University of Padova, Italy. suppiej@pediatria.unipd.it <suppiej@pediatria.unipd.it>
Cappellari
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A
Franzoi
M
M
Traverso
A
A
Ermani
M
M
Zanardo
V
V
D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D002675:Child, Preschool; D004569:Electroencephalography; D005073:Evoked Potentials, Somatosensory; D005074:Evoked Potentials, Visual; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D047929:Term Birth