Prédiction au moyen des potentiels évoqués endogènes et exogènes de l'évolution favorable d'un coma prolongé.
(1998) Neurophysiologie Clinique — Vol. 28, n° 4, p. 343-359 (1998)
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- Abstract
- A neurophysiological follow-up (EEG, exogenous and endogenous evoked potentials--EP) was performed over a 4-month period in a patient who presented a long-lasting coma following a cardiac arrest and an amniotic embolism. A pure anoxic aetiology was ruled out starting from the second day on the basis of a dissociation between mildly altered flash visual EP and markedly altered somatosensory EP, indicating focal brain-stem pathology. Endogenous EP reappeared after 12 days. This patient recovered consciousness after 51 days. Despite the absence of MRI abnormalities, we put forward the hypothesis that a brain-stem embolism had, in fact, worsened the clinical picture of an actually moderate anoxia. This case exemplifies the interest of an integrated neurophysiological approach (EEG, exogenous three-modality EP and endogenous EP) in the early evaluation of coma. It also illustrates the complement between structural imaging and functional assessment of the nervous system.
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Citations
Michel, C., Denison, S., Minne, C., & Guerit, J.-M. (1998). Prédiction au moyen des potentiels évoqués endogènes et exogènes de l’évolution favorable d’un coma prolongé. Neurophysiologie Clinique, 28(4), 343-359. https://doi.org/10.1016/S0987-7053(98)80005-1 (Original work published 1998)