Evoked potentials in comatose children: auditory brainstem responses.

Auditory brainstem responses (ABRs) were studied retrospectively in 80 children (ages 4 days to 19 years) with coma of various etiologies to determine their value as a predictor of outcome. The ABRs performed shortly after admission were analyzed with respect to initial neurologic status and final outcome. Of the 49 patients with initial Glasgow Coma Scale scores of less than 7, only 21 had severely abnormal ABRs. Eighteen had normal ABRs. Of these 18 patients, 10 died, and 8 were neurologically abnormal. Prolonged interpeak latencies were seen in 16 patients who experienced a range of clinical severity. Of the total of 17 children with absent ABRs or only the presence of waves I/III, three children survived, two with minimal neurologic abnormalities and one in a vegetative state. The efficacy of ABRs in comatose children as an early prognostic indicator was not confirmed by this study.