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2023, Number 1

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Rev Neurol Neurocir Psiquiat 2023; 51 (1)

Somatosensory evoked potentials, electroencephalogram and postanoxic coma: usefulness in neurological prognosis

Arciniegas-Villanueva AV, Fernández-Díaz EM, Mansilla-Lozano D, González-García E, Sancho-Pelluz FJ, Segura T

Language: Spanish
References: 35
Page: 4-12
PDF size: 304.76 Kb.


ABSTRACT

Introduction: after a postanoxic coma, the challenge for health professionals is to assess early the medium and long-term neurological prognosis. Despite improved prehospital care and measures focused on neuroprotection, postanoxic encephalopathy remains one of the main complications. The use of neurophysiological techniques such as short- and long-latency evoked potentials N20-N70 together with the electroencephalogram can be multimodal techniques that add and increase sensitivity and specificity in these patients. Objective: to define the relationship between short- and medium-latency N20-N70 somatosensory evoked potentials and electroencephalographic findings with mid- to long-term neurological prognosis in post-anoxic coma following cardiorespiratory arrest. Material and methods: retrospective cohort study conducted in patients admitted to the critical care units of our center with a diagnosis of post-anoxic coma. Scope Intensive Care and Resuscitation Unit of the Hospital General Universitario de Albacete. Participants 60 adult patients consecutively included after suffering cardiorespiratory arrest and consequently post-anoxic coma. Main variables of interest: somatosensory evoked potentials (presence or absence N20 and N70). Electroencephalogram (favorable and unfavorable findings). Assessment of functional prognosis using the modified Glasgow coma scale 6-12 months later. Results: bilateral absence of N20 has 100% specificity for ominous short-term prognosis. The presence of N70 has a specificity of 84% for good medium-long term prognosis and its absence shows a sensitivity of 92.7% for poor prognosis. Certain electroencephalographic findings are indicators of poor short-, medium- and long-term prognosis (specificity 100%, sensitivity 56%) while favorable findings were related to adequate recovery. Conclusions: the presence and absence of N20-N70 short- and long-latency somatosensory evoked potentials and electroencephalographic findings are related to the prediction of the neurological prognosis of patients after postanoxic coma. Our work especially highlights the usefulness of N70 as a prognostic factor after postanoxic coma.


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