Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia

Publication date: Available online 6 November 2017
Source:Clinical Neurophysiology
Author(s): Agnese Suppiej, Ambra Cappellari, Giacomo Talenti, Elisa Cainelli, Matteo Di Capua, Augusta Janes, Daniela Longo, Rodica Mardari, Cristina Marinaccio, Stefano Pro, Paola Sciortino, Daniele Trevisanuto, Roberta Vittorini, Renzo Manara
ObjectiveThe introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs).MethodsAmong 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4-14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI.ResultsBilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p<.001).ConclusionsBilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury.SignificanceTherapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.



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