title: Predict recovery of consciousness in post-acute severe brain injury: the role of EEG reactivity.
abstract: OBJECTIVE
  This study tested the hypothesis of electroencephalographic reactivity (EEG-R) as a reliable tool for the prognostic evaluation of consciousness recovery in post-acute brain injury.
  
  
  METHODS
  EEG was recorded in 50 unconscious patients. All patients had a GCS ≤8 and LCF score ≤2. They suffered from traumatic brain injury, cerebrovascular disease or anoxia. EEG was classified according to Synek classification (1988) as benign, malignant and 'uncertain significance'. EEG-R to painful stimuli was tested.
  
  
  RESULTS
  Twenty per cent of patients fulfilled the criteria for benign prognosis, 38% for malignant prognosis, while 42% of them were included in the 'uncertain' category, preventing them from stating a prognosis. EEG-R was detected in 48% of patients classified 'uncertain' and 92% of them recovered consciousness within 5 months from EEG recording. Multivariable analysis indicates that an unconscious patient admitted to the Rehabilitation Unit within 2 months from brain injury, with a LCF score equal to 2 and the presence of EEG-R has a probability of recovery of consciousness higher than 97%.
  
  
  CONCLUSIONS
  EEG-R is a good positive factor for the prognosis of recovery of consciousness in the post-acute phase of brain injury, with a high specificity (88.9%). Nevertheless, its absence is not invariably associated with a poor prognosis.
authors: Severe Acquired Brain Injury Unit, Multispecialistic Rehabilitation Centre , Auxilium Vitae Volterra , Italy. fiammettal@hotmail.com
authors: Fiammetta
authors: F
authors: Logi
authors: Patrizio
authors: P
authors: Pasqualetti
authors: Francesco
authors: F
authors: Tomaiuolo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003244:Consciousness Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D055815:Young Adult