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[利用诱发电位评估意识障碍患者的功能]

[Assessing the function of patients with consciousness disorders using evoked potentials].

作者信息

Schwarz G

机构信息

Klinik für Anästhesiologie, Universität Graz.

出版信息

Klin Wochenschr. 1988;66 Suppl 14:48-52.

PMID:3392901
Abstract

Multimodal evoked potentials (long latency somatosensory and visual evoked potentials, brainstem auditory evoked potentials) were performed in comatose patients. For the long-latency EP-components a signal-to-noise ratio (SNR) was calculated (SNR is defined as ratio of the largest EP-peak-to-peak amplitude and the mean amplitude of a period prior to the stimulation). An unmeasurable or questionable EP was defined when SNR less than 2.6. The highest correlation (r = 0.72) was found between the clinical state, represented by Glasgow Coma Score, and the SEP. The long latency SEPs appeared as a sensitive parameter in postacute states of brain disorders. The vertex VEP had a similar correlation (r = 0.66) to the clinical state; the occipital VEP showed no correlation. Emergency from coma and recovery was accompanied by an increasing spread of the VEP over the whole scalp. The use of auditory brainstem evoked potentials in coma and brain death ist demonstrated; applications and problems are discussed.

摘要

对昏迷患者进行了多模态诱发电位(长潜伏期体感诱发电位和视觉诱发电位、脑干听觉诱发电位)检查。对于长潜伏期诱发电位成分,计算了信噪比(SNR,定义为最大诱发电位峰峰值幅度与刺激前一段时间的平均幅度之比)。当SNR小于2.6时,定义为不可测量或有疑问的诱发电位。在以格拉斯哥昏迷评分表示的临床状态与体感诱发电位之间发现了最高的相关性(r = 0.72)。长潜伏期体感诱发电位在脑部疾病的急性后期状态中表现为一个敏感参数。头顶视觉诱发电位与临床状态有类似的相关性(r = 0.66);枕叶视觉诱发电位无相关性。从昏迷中苏醒和恢复伴随着视觉诱发电位在整个头皮上的扩散增加。展示了听觉脑干诱发电位在昏迷和脑死亡中的应用;讨论了其应用及问题。

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