EEG REACTIVITY IN THE PROGNOSIS OF SEVERE HEAD-INJURY

We compared reactivity of EEG to external stumuli-an easily and quickl y available measure-with the central conduction time (CCT) of the soma tosensory evoked potentials, currently the most-used electrophysiologi c method to predict outcome in severe head injury (SHI), and with the initial Glasgow Coma Scale (GCS) score. In 50 patients, comatose subse quent to SHI, we measured EEG reactivity and CCT within 48 to 72 hours and compared them with the outcome after 1.5 years. Using discriminan t analysis, EEG reactivity correctly classified 92%, CCT classified 82 %, and both measures together classified 98% of the patients into glob ally good or bad outcome groups. GCS allowed a correct classification in only 72% and, combined with either of the two electrophysiologic me asures, did not further increase predictability. EEG reactivity is an excellent long-term global outcome predictor in SHI, superior to CCT a nd GCS. When the two electrophysiologic measures are combined, a progn ostic accuracy is achieved that is better than that of any other repor ted method.