Document Detail

Medical technology assessment EEG and evoked potentials in the intensive care unit.
MedLine Citation:
PMID:  10546249     Owner:  NLM     Status:  MEDLINE    
We review the principal aspects of EEG and evoked potential (EP) neuromonitoring in the intensive care unit. The electrophysiological methods allow functional assessment of comatose patients and can be used (a) as a help to diagnose the origin of coma, (b) as a means to predict outcome, and (c) for monitoring purposes. The combination of the EEG and long-, middle-, and short-latency EPs allows widespread assessment of the cerebral cortex, the brain-stem, and the spinal cord. The EEG and the EP interpretation first requires taking into account non-neurological factors that may interfere with the recorded activities (sensory pathologies, toxic or metabolic problems, body temperature). The sensitivity and the specificity of any neurophysiological technique depend on the etiology of coma. Anoxic comas are associated with a predominantly cortical involvement, while the cortical and brain-stem functions are to be taken into account to interpret the EEG and the EPs in head trauma. The EEG and the EPs can be used to differentiate the comas due to structural lesions from those of metabolic origin, to confirm brain death and help to diagnose psychogenic unresponsiveness or a de-efferented state. While the prognostic value of the EEG is markedly hampered by the widespread use of sedative drugs, it has been possible to design efficient systems based on early- and middle-latency multimodality evoked potentials in anoxic and traumatic comas and, more generally, in all comas associated with an increase of the intracranial pressure. Continuous neuromonitoring techniques are currently under development. They have already been proven useful for the early detection and for the prevention of subclinical seizures, transtentorial herniation, vasospasm, and other causes of brain or spinal-cord ischemia.
J M Guérit
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurophysiologie clinique = Clinical neurophysiology     Volume:  29     ISSN:  0987-7053     ISO Abbreviation:  Neurophysiol Clin     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-12-15     Completed Date:  1999-12-15     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8804532     Medline TA:  Neurophysiol Clin     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  301-17     Citation Subset:  IM    
Clinical Neurophysiology Unit, university catholique de Louvain, Brussels, Belgium.
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MeSH Terms
Evoked Potentials / physiology*
Intensive Care / methods*
Intensive Care Units
Neurophysiology / instrumentation*

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