Important abnormalities in recordings of somatosensory evoked potentials in coma. 1991

V M Synek, and R V Trubuhovich
Department of Critical Care Medicine, Auckland Hospital, New Zealand.

We have chosen six illustrations showing how much vital information can be obtained from median nerve SEPs during the first 24 hours in coma. With avulsion of brachial plexus roots there was loss of SEPs at the cervical cord and the scalp from the affected side. In a severe injury of the cervical cord there was preservation of brachial plexus potentials, while SEPs at the cervical cord were absent. After critical deterioration in a case of repeated subarachnoidal hemorrhage, scalp SEPs with very short latency occurred, which is a finding suggestive of destruction of cortical SEP generators heralding a fatal outcome. In a case of brain injury combined with central hyperthermia, there was initially a loss of scalp SEPs probably due to the combined effect of these factors. In a case of brain injury there were bifid peaks at the scalp level. It is important to assess central sensory conduction time only to the first scalp SEP, otherwise an erroneously abnormal state may be inferred. In a patient with clinical and EEG evidence of brain death there was a loss of far-field thalamic potentials at the neck. It is important to be aware of such presentations to be able to provide corroborative assurance for the assessment of prognosis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001917 Brachial Plexus The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. Plexus, Brachial
D001926 Brain Death A state of prolonged irreversible cessation of all brain activity, including lower brain stem function with the complete absence of voluntary movements, responses to stimuli, brain stem reflexes, and spontaneous respirations. Reversible conditions which mimic this clinical state (e.g., sedative overdose, hypothermia, etc.) are excluded prior to making the determination of brain death. (From Adams et al., Principles of Neurology, 6th ed, pp348-9) Brain Dead,Coma Depasse,Irreversible Coma,Brain Deads,Coma, Irreversible,Death, Brain
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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