创伤性昏迷后是任其自生自灭还是积极救治：对体感诱发电位的审视
Let live or let die after traumatic coma: Scrutinizing somatosensory evoked potentials.
作者信息
Luauté Jacques, Cotton François, Lemaire Jean-Jacques, Tell Laurence, Iwaz Jean, Fischer Catherine, André-Obadia Nathalie
机构信息
Hospices Civils de Lyon (JL, LT), Hôpital Henry Gabrielle, Rééducation Neurologique, Lyon; INSERM, U1028 (JL), and CNRS, UMR5292 (JL), Lyon Neuroscience Research Center, IMPACT Team, Lyon; Université de Lyon (JL, FC, CF, NA-O), Université Lyon 1, Villeurbanne; Université de Lyon (FC), Université Lyon 1, Site Rockefeller, Laboratoire d'Anatomie, Lyon; Hospices Civils de Lyon (FC), Centre Hospitalier Lyon Sud, Service de Radiologie, Pierre Bénite; Université de Lyon (FC), Université Lyon 1, CREATIS-LRMN, CNRS UMR 5220, Lyon; INSERM U630 (FC), Villeurbanne; Centre Hospitalier Universitaire de Clermont-Ferrand (J-JL), Hôpital Gabriel Montpied, Service de Neurochirurgie, Clermont-Ferrand; Clermont Université (J-JL), Université d'Auvergne, IGCNC (Image-Guided Clinical Neuroscience and Connectomics), ISIT, Clermont-Ferrand; Hospices Civils de Lyon (JI), Service de Biostatistique, Lyon; INSERM, U1028 (CF), and CNRS, UMR5292 (CF), Lyon Neuroscience Research Center, Brain Dynamics and Cognition Team, Lyon; Hospices Civils de Lyon (CF, NA-O), Hôpital Neurologique Pierre Wertheimer, Neurologie Fonctionnelle, Bron; and Central Integration of Pain Lab (NA-O), Lyon Neuroscience Research Center, INSERM, U1028, CNRS, UMR5292, Bron, France.
出版信息
Neurol Clin Pract. 2012 Mar;2(1):24-32. doi: 10.1212/CPJ.0b013e31824c6cab.
It is now firmly established that bilateral abolition of somatosensory evoked potentials (SEPs) after a nontraumatic coma has 100% specificity for nonawakening. In traumatic coma, a bilateral absence of the N20 components of SEPs does not implicate nonawareness. Comatose brain-injured patients should be systematically explored with auditory evoked potentials to check the functional integrity of another sensory pathway and the mesencephalic tegmento-tectal region on cerebral MRI should be carefully examined. Repeated evaluations during follow-up are also mandatory.
现已明确证实，非创伤性昏迷后双侧体感诱发电位（SEP）消失对无法苏醒具有100%的特异性。在创伤性昏迷中，SEP的N20成分双侧缺失并不意味着无意识。对于昏迷的脑损伤患者，应系统地进行听觉诱发电位检查，以检查另一条感觉通路的功能完整性，并且应仔细检查脑部MRI上的中脑被盖-顶盖区域。随访期间的重复评估也是必不可少的。
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