Evoked potentials recorded during routine EEG predict outcome after perinatal asphyxia

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http://hdl.handle.net/10138/297841

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Nevalainen , P , Marchi , V , Metsäranta , M , Lönnqvist , T , Toiviainen-Salo , S , Vanhatalo , S & Lauronen , L 2017 , ' Evoked potentials recorded during routine EEG predict outcome after perinatal asphyxia ' , Clinical Neurophysiology , vol. 128 , no. 7 , pp. 1337-1343 . https://doi.org/10.1016/j.clinph.2017.04.025

Title: Evoked potentials recorded during routine EEG predict outcome after perinatal asphyxia
Author: Nevalainen, Päivi; Marchi, Viviana; Metsäranta, Marjo; Lönnqvist, Tuula; Toiviainen-Salo, Sanna; Vanhatalo, Sampsa; Lauronen, Leena
Contributor: University of Helsinki, HUS Medical Imaging Center
University of Helsinki, HUS Children and Adolescents
University of Helsinki, HUS Children and Adolescents
University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2017-07
Language: eng
Number of pages: 7
Belongs to series: Clinical Neurophysiology
ISSN: 1388-2457
URI: http://hdl.handle.net/10138/297841
Abstract: Objective: To evaluate the added value of somatosensory (SEPs) and visual evoked potentials (VEPs) recorded simultaneously with routine EEG in early outcome prediction of newborns with hypoxicischemic encephalopathy under modern intensive care. Methods: We simultaneously recorded multichannel EEG, median nerve SEPs, and flash VEPs during the first few postnatal days in 50 term newborns with hypoxic-ischemic encephalopathy. EEG background was scored into five grades and the worst two grades were considered to indicate poor cerebral recovery. Evoked potentials were classified as absent or present. Clinical outcome was determined from the medical records at a median age of 21 months. Unfavorable outcome included cerebral palsy, severe mental retardation, severe epilepsy, or death. Results: The accuracy of outcome prediction was 98% with SEPs compared to 90% with EEG. EEG alone always predicted unfavorable outcome when it was inactive (n = 9), and favorable outcome when it was normal or only mildly abnormal (n = 17). However, newborns with moderate or severe EEG background abnormality could have either favorable or unfavorable outcome, which was correctly predicted by SEP in all but one newborn (accuracy in this subgroup 96%). Absent VEPs were always associated with an inactive EEG, and an unfavorable outcome. However, presence of VEPs did not guarantee a favorable outcome. Conclusions: SEPs accurately predict clinical outcomes in newborns with hypoxic-ischemic encephalopathy and improve the EEG-based prediction particularly in those newborns with severely or moderately abnormal EEG findings. Significance: SEPs should be added to routine EEG recordings for early bedside assessment of newborns with hypoxic-ischemic encephalopathy. (C) 2017 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Subject: Somatosensory evoked potentials
Visual evoked potentials
Electroencephalography
Asphyxia
Newborn
Brain monitoring
HYPOXIC-ISCHEMIC ENCEPHALOPATHY
TERM BIRTH ASPHYXIA
NEONATAL ENCEPHALOPATHY
PROGNOSTIC VALUE
BRAIN-INJURY
THERAPEUTIC HYPOTHERMIA
INFANTS
AMPLITUDE
PATTERNS
NEWBORNS
3112 Neurosciences
3124 Neurology and psychiatry
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