title: Somatosensory evoked potentials are of additional prognostic value in certain patterns of brain injury in term birth asphyxia.
abstract: OBJECTIVE
  (a) To relate MRI patterns of brain injury to somatosensory evoked potentials (SEPs), and (b) to determine the prognostic value of SEPs in addition to continuous EEG monitoring (cEEG) and cerebral imaging, in term asphyxiated newborns.
  
  
  METHODS
  Fifty one consecutive neonates were studied. Survivors were followed for at least 2 years. cEEG, started within 24h, was done for ≥ 24 h and scored. SEPs and MRIs were performed in the first week. Brain injury patterns were classified.
  
  
  RESULTS
  Bilaterally abnormal SEPs had a sensitivity of 90% (28/31) and specificity of 85% (17/20) in predicting a poor outcome, defined as death or severe handicap. SEPs were of particular value in predicting outcome in isolated symmetrical white matter injury and predicting the development of hemiparesis in isolated asymmetrical watershed injury. Binary logistic regression analysis revealed a significant relation to outcome separately for cEEG, deep grey matter injury on MRI and SEPs. SEPs provided additional value when added to cEEG and MRI in the model (p=0.034).
  
  
  CONCLUSIONS
  SEPs are of additional prognostic value after term birth asphyxia.
  
  
  CONCLUSIONS
  In certain patterns of postasphyxial neonatal brain injury like asymmetrical watershed lesions and symmetrical white matter injury, EPs are complementary to information obtained from cEEG and MRI for prognostication.
authors.affiliation: Department of Neonatology, Erasmus MC-Sophia, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. r.swarte@erasmusmc.nl
authors.forename: Renate M C
authors.initials: RM
authors.lastname: Swarte
authors.forename: Perumpillichira J
authors.initials: PJ
authors.lastname: Cherian
authors.forename: Maarten
authors.initials: M
authors.lastname: Lequin
authors.forename: Gerhard H
authors.initials: GH
authors.lastname: Visser
authors.forename: Paul
authors.initials: P
authors.lastname: Govaert
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D004569:Electroencephalography; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011379:Prognosis; D012640:Seizures / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology