Predicting the fate of ICU patients who are in coma is extremely challenging. In this context, somatosensory evoked potential (SSEP) can assist the multimodal neurological evaluation. In this chapter, we discuss the principles, applications and limitations of the SSEP in the ICU, with a focus on prognostication in comatose patients. Registration of the SSEP is a very reliable and reproducible method, if performed and interpreted correctly. During recordings, great care should be taken in improving the signal-to-noise ratio: if the noise level is too high, the peripheral responses are abnormal, or the response is not reproducible in a second set of stimuli; in these cases, interpretation of the SSEP cannot be done reliably. A bilaterally absent cortical response is a reliable predictor for poor neurological outcome in patients with a postanoxic coma, but not in patients with traumatic brain injury or stroke.
|Title of host publication||Clinical Neurophysiology in Disorders of Consciousness|
|Subtitle of host publication||Brain Function Monitoring in the ICU and Beyond|
|Editors||Andrea O. Rossetti, Steven Laureys|
|Number of pages||8|
|Publication status||Published - 1 Jan 2015|