EVALUATION AND PROGNOSTICATION IN COMA

Electroencephalography (EEG) and evoked potential (EP) studies are neu rophysiologic techniques which provide information on physiological st ate and response to therapy, and may aid diagnosis and prognosis. Seri al studies or continuous monitoring may enable changes to be detected prior to irreversible deterioration in the patient's condition. Curren t computer technology allows simultaneous display and correlation of e lectrophysiologic parameters, cardiovascular state and ICP. Continuous EEG monitoring in the ICU has been shown to have a decisive or contri buting impact on medical decision making in more than three-quarters o f patients. In addition, continuous EEG monitoring has revealed previo usly unsuspected non-convulsive seizures in two-thirds of patients. So matosensory and auditory EPs can provide useful prognostic information in coma patients, however, these tests are etiologically non-specific and must be carefully integrated into the clinical situation. Motor E Ps offer a potentially useful tool for evaluating motor system abnorma lities in the ICU. Thus, neurophysiologic tests are established monito ring tools in the neurological intensive careunit. (C) 1998 Elsevier S cience Ireland Ltd.