Somatosensory evoked potentials predict neurologic outcome in full-term neonates with asphyxia

Somatosensory evoked potentials in children with bilateral spastic cerebral palsy

Alterations were monitored of somatosensory evoked potentials in children with bilateral spastic cerebral palsy and these findings correlated with relevant clinical and laboratory parameters. Fifty-one children with bilateral spastic cerebral palsy (31 boys, 20 girls; age range 24-168 months) participated in the study. Abnormal somatosensory evoked potentials latencies were recorded in 23 of 34 (67.6%) cortical recordings of the median nerve and in 38 of 51 (74.5%) cortical recordings of the tibial nerve. Abnormal tibial nerve somatosensory evoked potentials were strongly correlated with abnormal electroencephalogram (P=0.014), while impaired median nerve recordings were correlated with abnormal visual evoked potentials (P = 0.02) and a history of perinatal or neonatal infection (P=0.016). Furthermore, perinatal/neonatal infection adversely effected the recordings in both tibial and medial nerves in quadriplegic patients (P=0.023). Sensory impairment is strongly related with abnormal visual evoked potentials, abnormal electroencephalogram, and a history of perinatal or neonatal infection.

The value of brainstem evoked potential in clinical decision of a patient with hypoxic-ischemic encephalopathy

Establishing a prognosis for hypoxic-ischemic encephalopathy during the neonatal period is extremely difficult, as the neuroplasticity of the developing brain makes it almost impossible to measure the affected area. This case report describes a newborn with severe perinatal asphyxia and neonatal neurological syndrome including absent suck reflex. Normal brainstem auditory evoked potential led the diagnosis towards a transitory dysfunction of deglutition, and the subject received daily stimulation in the hospital environment. Suck developed satisfactorily by day of life 30 and the patient was released without having to be tube fed. Neurophysiologic tests can be of value in the clinical decisions and analysis of functional prognosis of patients with hypoxic-ischemic encephalopathy.

Long-term developmental outcome of asphyxiated term neonates

Asphyxia remains one of the main causes of later disability in term infants. Despite many publications identifying possible predictors of outcome in this population of interest, little is known of the long-term developmental outcome of asphyxiated term neonates. Observational studies have largely focused on short-term outcomes, with an emphasis on significant neurologic sequelae and intellectual impairments. This article reviews the literature that has described the developmental outcome of asphyxiated term newborns. As part of this review, we have also highlighted the evolution of the definition of asphyxia and delineated appropriate markers that should be used in future research on this population.

Neonatal neurologic prognostication: the asphyxiated term newborn

The pediatric neurologist is often requested to predict the neurologic outcome in an uncertain situation. A common and problematic clinical setting in which this occurs is the asphyxiated term newborn. This report reviews the predictive tools available for prognostication in this situation and formulates a practical paradigm that the authors hope will improve predictive accuracy and lessen uncertainty in this setting.