A preliminary prospective neurophysiological study of coma in children
P. Strickbine-Van Reet, D. G. Glaze and R. A. Hrachovy
Electroencephalograms, brain-stem auditory evoked potentials (BAEPs),
visual evoked potentials to diffuse flash (FVEPs), and neurological
examinations were performed on 17 comatose children within the first 24
hours of the onset of coma and serially thereafter; the results were
correlated with clinical outcome. Children with initially unrecordable
FVEPs had poor outcomes; of ten children, five died and five survived with
severe neurological deficits. Initially recordable FVEPs in seven children
were associated with survival; six of the seven had mild to no neurological
residua. Impaired brain-stem function, determined on initial neurological
examination, was associated with survival in children with normal BAEPs.
All patients with intact brain-stem function survived, but the best outcome
was seen in those with recordable FVEPs. Studies of FVEPs and BAEPs are
useful in the assessment of coma in children and provide prognostic
information concerning the consequences of the underlying insult.
