Predictive value of electrophysiology in children with hypoxic coma

Mewasingh, Leena D.; Christophe, Catherine; Fonteyne, Christine; Dachy, Bernard; Ziereisen, France; Christiaens, Florence; Deltenre, Paul; De Maertelaer, Viviane; Dan, Bernard

doi:10.1016/S0887-8994(02)00509-X

« Previous Next »Pediatric Neurology
Volume 28, Issue 3 , Pages 178-183, March 2003

Predictive value of electrophysiology in children with hypoxic coma

Leena D. Mewasingh, MD
- Department of Neurology, Children’s University Hospital Queen Fabiola, Brussels, Belgium
Catherine Christophe, MD
- Department of Neuroradiology, Children’s University Hospital Queen Fabiola, Brussels, Belgium
Christine Fonteyne, MD
- Intensive Care Unit, Children’s University Hospital Queen Fabiola, Brussels, Belgium
Bernard Dachy, MD
- Department of Neurophysiology, Brugmann University Hospital, Brussels, Belgium
France Ziereisen, MD
- Department of Neuroradiology, Children’s University Hospital Queen Fabiola, Brussels, Belgium
Florence Christiaens, MD
- Department of Neurology, Children’s University Hospital Queen Fabiola, Brussels, Belgium
Paul Deltenre, MD, PhD
- Department of Neurophysiology, Brugmann University Hospital, Brussels, Belgium
Viviane De Maertelaer, PhD
- IRIBHM, Statistical Unit, Free University of Brussels, Brussels, Belgium
- Communications should be addressed to: Dr. Dan; Professor of Developmental Pediatrics; Children’s University Hospital Queen Fabiola; Ave JJ Crocq 15; 1020 Brussels, Belgium.
Bernard Dan, MD, PhD
- Department of Neurology, Children’s University Hospital Queen Fabiola, Brussels, Belgium

Received 19 March 2002; accepted 5 September 2002.

Abstract

Assessment of prognosis of children in hypoxic coma is difficult. The value of clinical evaluation is often limited. The usefulness of electrophysiologic tests has been documented mostly in adults and neonates and in cases of traumatic coma. We reviewed retrospectively 39 consecutive children with nontraumatic hypoxic coma to assess the prognostic value of EEG, visual, and auditory evoked potentials. Correlation between electrophysiology and neurologic outcome after mean follow-up period of 30 months was significant (r_s = 0.6, P < 0.001). In contrast there was no correlation between Pediatric Risk of Mortality score (PRISM) and outcome (r_s = −0.42, P = 0.8). Combining magnetic resonance imaging with electrophysiology further enhanced their prognostic value (r_s = 0.69, P < 0.001). Neuroimaging was highly sensitive but less specific, and electrophysiologic tests were highly specific but less sensitive. We conclude that early electrophysiology can contribute to predicting outcome in pediatric hypoxic coma.