MULTIMODALITY EVOKED-POTENTIALS AS A PROGNOSTIC TOOL IN TERM ASPHYXIATED NEWBORNS

Hypoxic-ischemic (HI) events may cause permanent brain damage, and it is difficult to predict the long-term neurological outcome of survivor s. Multimodality evoked potentials (MEPs), using flash visual (fVEPs), somatosensory (SEPs), and brain-stem auditory evoked potentials (BAEP s) may assess the cerebral function in term neonates. MEPs were record ed in 40 hypoxic-ischemic term or near-term neonates during the first week of life in order to predict the neurological outcome. A 3 point g rading system registered either mild, moderate, or severe abnormalitie s. At 24 months of corrected age, the infants were assessed with a bli nd protocol to determine neurological development. Grade 0 fVEPs and S EPs were associated with a normal neurological status with 100% (P < 0 .001) of the infants. Abnormal SEPs or total grade (VEPs + SEPs) > I w ere not associated with normal outcomes (P < 0.0001). Normal BAEPs did not predict a normal outcome, but severely abnormal BAEPs did predict an abnormal outcome. A significant correlation was found between EP ( VEPs + SEPs) grade (r = 0.9, P < 0.0001), Sarnat stage (r = 0.6, P < 0 .001), and clinical outcome. This study confirmed that both fVEPs and SEPs are more accurate as prognostic indicators for term neonates. EPs (VEPs + SEPs) also are more accurate in predicting the ultimate neuro logical outcome compared with the Sarnat scoring. (C) 1998 Elsevier Sc ience Ireland Ltd.