Department of Rehabilitation Medicine, University of Washington School of Medicine, P.O. Box 356380, Seattle, WA 98195, USA.
Neurocrit Care. 2010 Feb;12(1):69-73. doi: 10.1007/s12028-009-9191-2. Epub 2009 Feb 19.
It is unclear whether the rate of stimulation for somatosensory evoked potentials (SEPs) can influence the presence or absence of cortical responses to median nerve stimulation in comatose patients. If so, this could affect how SEPs are performed and interpreted for prognostication in coma. Our objective was to determine how frequently our comatose patients had absent median nerve SEP responses at 3 Hz stimulation, but present responses at 1 Hz stimulation, and to report outcomes of these patients.
We reviewed SEP recordings in 639 comatose patients over a 9-year period. All had stimulation at 3 Hz and 1 Hz. This is a retrospective review.
There were seven patients who had absent median nerve SEP responses at 3 Hz stimulation bilaterally, but had present responses at 1 Hz on one or both sides. Six of the seven died. One 16-year-old patient with traumatic brain injury awoke, but had moderate disability.
Stimulation rate is an important determinant of presence or absence of cortical responses in about 1% of comatose patients. It is unclear whether such patients have a different outcome that those with absent responses at both rates of stimulation.
目前尚不清楚体感诱发电位（SEP）的刺激频率是否会影响昏迷患者正中神经刺激时皮质反应的存在或缺失。如果是这样，这可能会影响 SEP 的进行方式以及昏迷患者的预后解读。我们的目的是确定在 3 Hz 刺激时，我们的昏迷患者中有多少人出现正中神经 SEP 反应缺失，但在 1 Hz 刺激时有反应，并报告这些患者的结局。
我们回顾了 9 年间 639 例昏迷患者的 SEP 记录。所有患者均接受了 3 Hz 和 1 Hz 的刺激。这是一项回顾性研究。
有 7 例患者双侧 3 Hz 刺激时正中神经 SEP 反应缺失，但单侧或双侧 1 Hz 刺激时有反应。这 7 例患者中有 6 例死亡。1 例 16 岁的创伤性脑损伤患者苏醒，但有中度残疾。
刺激频率是昏迷患者约 1%的皮质反应存在或缺失的一个重要决定因素。目前尚不清楚在两种刺激频率下均无反应的患者是否具有不同的结局。
