title: EEG, evoked potentials and pulsed Doppler in asphyxiated term infants.
abstract: OBJECTIVE
  To evaluate electroencephalograms (EEG), evoked potentials (EPs) and Doppler findings in the cerebral arteries as predictors of a 1-year outcome in asphyxiated newborn infants.
  
  
  METHODS
  EEG and EPs (brain stem auditory (BAEP), somatosensory (SEP), visual (VEP) evoked potentials) were assessed in 30 asphyxiated and 30 healthy term infants during the first days (range 1-8). Cerebral blood flow velocities (CBFV) were measured from the cerebral arteries using pulsed Doppler at ∼24h of age. EEG, EPs, Doppler findings, symptoms of hypoxic ischemic encephalopathy (HIE) and their combination were evaluated in predicting a 1-year outcome.
  
  
  RESULTS
  An abnormal EEG background predicted poor outcome in the asphyxia group with a sensitivity of 67% and 81% specificity, and an abnormal SEP with 75% and 79%, respectively. Combining increased systolic CBFV (mean+3SD) with abnormal EEG or SEP improved the specificity, but not the sensitivity. The predictive values of abnormal BAEP and VEP were poor. Normal EEG and SEP predicted good outcome in the asphyxia group with sensitivities from 79% to 81%. The combination of normal EEG, normal SEP and systolic CBFV<3SD predicted good outcome with a sensitivity of 74% and 100% specificity.
  
  
  CONCLUSIONS
  Combining abnormal EEG or EPs findings with increased systolic CBFV did not improve prediction of a poor 1-year outcome of asphyxiated infants. Normal EEG and normal SEP combined with systolic CBFV<3SD at about 24 h can be valuable in the prediction of normal 1-year outcome.
  
  
  CONCLUSIONS
  Combining systolic CBFV at 24 h with EEG and SEP examinations can be of use in the prediction of normal 1-year outcome among asphyxiated infants.
authors.affiliation: Pediatric Research Centre, University of Tampere, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland. Electronic address: mia.julkunen@fimnet.fi.
authors.forename: Mia K
authors.initials: MK
authors.lastname: Julkunen
authors.affiliation: Department of Clinical Neurophysiology, Tampere University Hospital, Tampere, Finland; Faculty of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Sari-Leena
authors.initials: SL
authors.lastname: Himanen
authors.affiliation: Pediatric Research Centre, University of Tampere, Tampere, Finland; Pediatric Neurology Unit, Tampere University Hospital, Tampere, Finland.
authors.forename: Kai
authors.initials: K
authors.lastname: Eriksson
authors.affiliation: Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
authors.forename: Martti
authors.initials: M
authors.lastname: Janas
authors.affiliation: Science Center, Pirkanmaa Hospital District, Tampere School of Public Health, University of Tampere, Tampere, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.affiliation: Pediatric Research Centre, University of Tampere, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Tammela
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D001238:Asphyxia Neonatorum / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D004569:Electroencephalography; D005071:Evoked Potentials; D016057:Evoked Potentials, Auditory, Brain Stem; D005073:Evoked Potentials, Somatosensory; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D012640:Seizures / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D018617:Ultrasonography, Doppler, Pulsed
chemical_list: D000927:Anticonvulsants
keywords: Asphyxia; Doppler; Electroencephalogram; Evoked potentials; Hypoxic-ischemic encephalopathy; Outcome