A Preliminary Prospective Neurophysiological Study of Coma in Children

• Electroencephalograms, brain-stem auditory evoked potentials (BAEPs), visual evoked potentials to diffuse flash (FVEPs), and neurological examinations were performed on 17 comatose children within the first 24 hours of the onset of coma and serially thereafter; the results were correlated with clinical outcome. Children with Initially unrecordable FVEPs had poor outcomes; of ten children, five died and five survived with severe neurological deficits. Initially recordable FVEPs in seven children were associated with survival; six of the seven had mild to no neurological residua. Impaired brain-stem function, determined on initial neurological examination, was associated with survival in children with normal BAEPs. All patients with Intact brain-stem function survived, but the best outcome was seen in those with recordable FVEPs. Studies of FVEPs and BAEPs are useful in the assessment of coma in children and provide prognostic Information concerning the consequences of the underlying insult.

(AJDC 1984;138:492-495)