A preliminary study of multimodal evoked potentials in relation to outcome in term infants with post-asphyxial hypoxic-ischemic encephalopathy

Abstract

Prediction of neurological sequelae following hypoxic-ischemic encephalopathy is difficult. In the present study, the prognostic value of multimodal evoked potentials including visual evoked potentials (VEPs), auditory brainstem responses (ABRs) and somatosensory evoked potentials, recorded within the first week after birth, was determined in relation to adverse neurological outcome for 20 asphyxiated term-infants at 1 year of age. Five infants developed severe neurological sequelae (spastic quadriplegia, diplegia, choreoathetosis), two had delayed milestones, one died while 12 were normal. The combined utilization of VEPs and ABRs were highly predictive for outcome, allowing 100% and 88.9% positive and negative predictive values respectively compared to 71.4% (positive predictive value) and 77% (negative predictive value) for somatosensory evoked potentials. This study confirms that evoked potentials are accurate tools and useful adjuncts to clinical assessment for predicting outcome of hypoxic-ischemic encephalopathy. Their accuracy increased when VEPs and ABRs are used concordantly.

Keywords

Birth asphyxia - hypoxic-ischemic encephalopathy - evoked potential