THE USE OF EVOKED-POTENTIALS IN THE NEONATAL INTENSIVE-CARE UNIT

The data reported in the literature and our own findings have shown, t hat evoked potentials (EPs) can be performed at the bedside and provid e additional information about the integrity of the central nervous sy stem. Auditory brainstem responses (ABRs) are especially useful for ea rly identification of audiological problems and whenever possible, at risk newborn infants (table Tr) should be screened using either ABRs o r other methods Like the otoacoustic emission before discharge. ABRs a ppear to be less useful in predicting neurological impairment, especia lly in the preterm infant. Visual evoked potentials (VEPs) can easily be performed at the bedside and are of predictive value for both neuro logical and visual outcome in the fullterm infant with hypoxic ischaem ic encephalopathy (HIE) and the preterm infant in whom the cysts exten d into the deep white matter. VEPs will help to identify at an early s tage those infants who will suffer severe visual impairment being cort ically mediated. Somatosensory evoked potentials (SEPs) are the most d ifficult to perform of the EPs, but adapting filter settings and stimu lation rate it is also possible to obtain responses following stimulat ion of both the median and posterior tibial nerve. Median nerve SEPs a re of predictive value in the fullterm infant with WIE with regard to neurodevelopmental outcome. In the preterm infant however, the predict ive value is not so good for the median nerve and more data an needed to assess the predictive value of the posterior tibial nerve SEP.