EEG and Auditory brainstem response are valuable as prognostic predictors of pediatric coma either due to medical or surgical causes. The Glasgow Coma Scale (GCS) has several important limitations as a predictor of survival in the general critically ill population while CT brain is mostly important for diagnostic rather than prognostic factor in comatosed children. Coma and other states of impaired consciousness represent a medical emergency in pediatric Intensive Care Unit (ICU). The potential causes are numerous, and the critical window for diagnosis and effective intervention is often short. The common causes of non-traumatic coma include central nervous system infections, metabolic encephalopathy intracranial hemorrhage, and stroke and status epilepticus. Evoked Potentials (EPs) remain a unique tool to demonstrate brainstem dysfunction interfering with Brainstem Auditory Evoked Potentials (BAEPs) and/or Somatosensory Evoked Potentials (SEPs). In some instances, BAEPs can demonstrate unexpected brainstem lesions in patients who were initially considered as post-anoxic, in which case heart failure or respiratory arrest are likely to be the consequence of primary brainstem damage rather than the primary cause of coma.
Last date updated on July, 2014