Serial evoked potentials and outcome in cerebrovascular critical care patients

Median-nerve evoked somatosensory evoked potentials (SEPs) and brainstem au ditory evoked potentials (BAEPs), examined early in the course of patients suffering from cerebrovascular disease, correlate statistically significant ly with outcome. Little is known about the changes of evoked potentials in the course of disease and their correlation to outcome. in a series of 215 patients (75 supratentorial infarctions, 36 infratentorial infarctions, 58 supratentorial hemorrhages, 18 infratentorial hemorrhages, and 28 aneurysma tic subarachnoid hemorrhages) requiring neurologic intensive care treatment , we prospectively examined the correlation between the findings of serial SEPs and BAEPs and outcome at 4 weeks. Evoked potentials were examined afte r admission, after 1 week, and after 2 weeks. The findings were classified in 4 categories (normal, unilateral or bilateral pathologic findings, unila terally attenuated, and bilaterally attenuated). Clinical outcome was deter mined by classification according to the Glasgow Outcome Scale (death, pers istent vegetative state, severely incapacitated, mildly incapacitated, and recovery). Statistical evaluation was performed using Fisher's exact test f or all variables. In all subgroups, SEPs correlated statistically significa ntly with outcome at all three examinations. No correlation was found for B AEPs at first examination in infratentorial disease, nor at second examinat ion in subarachnoid hemorrhages. In all other eases, SEPs and BAEPs were co rrelated statistically significantly with outcome at all three examination timepoints.