Somatosensory evoked potentials are of additional prognostic value in certain patterns of brain injury in term birth asphyxia.

OBJECTIVE

(a) To relate MRI patterns of brain injury to somatosensory evoked potentials (SEPs), and (b) to determine the prognostic value of SEPs in addition to continuous EEG monitoring (cEEG) and cerebral imaging, in term asphyxiated newborns.

METHODS

Fifty one consecutive neonates were studied. Survivors were followed for at least 2 years. cEEG, started within 24h, was done for ≥ 24 h and scored. SEPs and MRIs were performed in the first week. Brain injury patterns were classified.

RESULTS

Bilaterally abnormal SEPs had a sensitivity of 90% (28/31) and specificity of 85% (17/20) in predicting a poor outcome, defined as death or severe handicap. SEPs were of particular value in predicting outcome in isolated symmetrical white matter injury and predicting the development of hemiparesis in isolated asymmetrical watershed injury. Binary logistic regression analysis revealed a significant relation to outcome separately for cEEG, deep grey matter injury on MRI and SEPs. SEPs provided additional value when added to cEEG and MRI in the model (p=0.034).

CONCLUSIONS

SEPs are of additional prognostic value after term birth asphyxia.

SIGNIFICANCE

In certain patterns of postasphyxial neonatal brain injury like asymmetrical watershed lesions and symmetrical white matter injury, EPs are complementary to information obtained from cEEG and MRI for prognostication.