Association between somatosensory evoked potentials and EEG in comatose patients after cardiac arrest. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Glimmerveen, Astrid B.; Ruijter, Barry J.; Keijzer, Hanneke M.; Tjepkema-Cloostermans, Marleen C.; van Putten, Michel J.A.M.; Hofmeijer, Jeannette
• Is Part Of: Clinical neurophysiology. Volume 130:Issue 11(2019:Nov.)
• Page Start: 2026
• Page End: 2031
• Publication Date: 2019-11
• Subjects: EEG -- SSEP -- Prognosis -- Postanoxic coma -- Cardiac arrest; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2019.08.022
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Absent SSEP and suppressed or synchronous EEG on suppressed background predict poor outcome. SSEP is either present or absent, with no changes over the first 5 days. SSEP cannot be predicted by EEG patterns, except for preserved N20 in normal EEG. Abstract: Objective: To analyze the association between SSEP results and EEG results in comatose patients after cardiac arrest, including the added value of repeated SSEP measurements. Methods: Continuous EEG was measured in 619 patients during the first 3–5 days after cardiac arrest. SSEPs were recorded daily in the first 55 patients, and on indication in later patients. EEGs were visually classified at 12, 24, 48, and 72 h after cardiac arrest, and at the time of SSEP. Outcome at 6 m was dichotomized as good (Cerebral Performance Category 1–2) or poor (CPC 3–5). SSEP and EEG results were related to outcome. Additionally, SSEP results were related to the EEG patterns at the time of SSEP. Results: Absent SSEP responses and suppressed or synchronous EEG on suppressed background ≥24 h after cardiac arrest were invariably associated with poor outcome. SSEP and EEG identified different patients with poor outcome (joint sensitivity 39% at specificity 100%). N20 responses were always preserved in continuous traces at >8 Hz. Absent SSEPs did not re-emerge during the first five days. Conclusions: SSEP and EEG results may diverge after cardiac arrest. Significance: SSEP and EEG together identify more patients without chance of recovery than one of these alone.