Predictive value of sensory and cognitive evoked potentials for awakening from coma.

Abstract:

OBJECTIVES:To determine the prognostic role of late auditory (N100) and cognitive evoked potentials (MMN) for awakening in a cohort of comatose patients categorized by etiology. METHODS:The authors prospectively studied a series of 346 comatose patients. Coma was caused by stroke (n = 125), trauma (n = 96), anoxia (n = 64), complications of neurosurgery (n = 54), and encephalitis (n = 7). Patients were followed for 12 months and classified as awake or unawake. Univariate and multivariate analyses were performed using regression logistic and Cox models. RESULTS:Pupillary light reflex, N100, middle-latency auditory evoked potentials, age, and etiology were the most discriminating factors for awakening. Statistical analysis showed that pupillary reflex was the strongest prognostic variable for awakening (estimated probability 79.7%). The estimated probability of awakening rose to 87% when N100 was present and to 89.9% when middle-latency evoked potentials (MLAEPs) were present. It was 13.7% when pupillary reflex was absent in anoxic patients. When MMN was present, 88.6% of patients awakened. No patient in whom MMN was present became permanently vegetative. CONCLUSION:Pupillary reflex is the strongest prognostic variable, followed by N100 and MLAEPs allowing a reliable model for awakening. The presence of MMN is a predictor of awakening and precludes comatose patients from moving to a permanent vegetative state. Evaluation of primary sensory cortex and higher-order processes by middle-latency-, late, and cognitive evoked potentials should be performed in the prognosis for awakening in comatose patients.

journal_name

Neurology

journal_title

Neurology

authors

Fischer C,Luauté J,Adeleine P,Morlet D

doi

10.1212/01.wnl.0000134670.10384.e2

subject

Has Abstract

pub_date

2004-08-24 00:00:00

pages

669-73

issue

4

eissn

0028-3878

issn

1526-632X

pii

63/4/669

journal_volume

63

pub_type

杂志文章
  • Longitudinal evaluation of dementia of the Alzheimer type: a comparison of 3 standardized mental status examinations.

    abstract::We administered 3 commonly employed tests of mental status (the Information-Memory-Concentration test [IMC], the Mini-Mental State Examination [MMSE], and the Dementia Rating Scale [DRS]) to 92 patients with probable dementia of the Alzheimer type. The 3 tests were readministered to 55 of the patients (2-year subgroup...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.40.8.1225

    authors: Salmon DP,Thal LJ,Butters N,Heindel WC

    更新日期:1990-08-01 00:00:00

  • Double-blind, randomized, placebo-controlled study of oral, high-dose methylprednisolone in attacks of MS.

    abstract:OBJECTIVE:There is only limited evidence from adequately controlled clinical trials to support high-dose methylprednisolone therapy for attacks of multiple sclerosis (MS) and none supporting oral administration. We assessed the effect of oral high-dose methylprednisolone therapy in attacks of MS. METHODS:Twenty-five p...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.51.2.529

    authors: Sellebjerg F,Frederiksen JL,Nielsen PM,Olesen J

    更新日期:1998-08-01 00:00:00

  • Correlations between magnetization transfer metrics and other magnetic resonance abnormalities in multiple sclerosis.

    abstract::Magnetization transfer imaging (MTI) is a magnetic resonance imaging (MRI) technique that is now used in multiple sclerosis (MS) studies, and is thought to have a higher pathological specificity than conventional T2-weighted imaging. This review outlines the correlations between magnetization transfer (MT) metrics and...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:

    authors: Rovaris M,Horsfield MA,Filippi M

    更新日期:1999-01-01 00:00:00

  • Restless legs syndrome: treatment with dopaminergic agents.

    abstract::Restless legs syndrome (RLS) is a common neurologic disorder that affects 5 to 10% of the population and increases in prevalence with aging. The clinical hallmarks of RLS include dysesthesias or paresthesias in the legs and sometimes the arms, occurring primarily at rest, which are usually worse in the evening and are...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:10.1212/wnl.58.suppl_1.s87

    authors: Comella CL

    更新日期:2002-02-26 00:00:00

  • Discontinuation of anticonvulsant therapy in children with partial epilepsy.

    abstract::To evaluate when it is possible to discontinue anticonvulsant treatment in children with cryptogenic partial epilepsy, the authors studied 89 epileptic children divided into two groups: Group A, 45 children whose therapy was discontinued after 1 year from the last seizure; and Group B, 44 children whose therapy was st...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.55.9.1393

    authors: Verrotti A,Morresi S,Basciani F,Cutarella R,Morgese G,Chiarelli F

    更新日期:2000-11-14 00:00:00

  • Serum folate and chronic fatigue syndrome.

    abstract::We assayed serum folate levels of 60 patients with chronic fatigue syndrome (CFS) and found that 50% had values below 3.0 micrograms/l. Some patients with CFS are deficient in folic acid. ...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.12.2645

    authors: Jacobson W,Saich T,Borysiewicz LK,Behan WM,Behan PO,Wreghitt TG

    更新日期:1993-12-01 00:00:00

  • Vitamin D, smoking, EBV, and long-term cognitive performance in MS: 11-year follow-up of BENEFIT.

    abstract:OBJECTIVE:To investigate whether vitamin D, smoking, and anti-Epstein-Barr virus (EBV) antibody concentrations predict long-term cognitive status and neuroaxonal injury in multiple sclerosis (MS). METHODS:This study was conducted among 278 patients with clinically isolated syndrome who participated in the clinical tri...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000009371

    authors: Cortese M,Munger KL,Martínez-Lapiscina EH,Barro C,Edan G,Freedman MS,Hartung HP,Montalbán X,Foley FW,Penner IK,Hemmer B,Fox EJ,Schippling S,Wicklein EM,Kappos L,Kuhle J,Ascherio A,BENEFIT Study Group.

    更新日期:2020-05-05 00:00:00

  • Prevalence of MRI abnormalities in people with epilepsy in rural China.

    abstract:OBJECTIVE:To assess the prevalence of brain MRI abnormalities in people with epilepsy in rural China and to compare it with that of individuals in the United Kingdom. METHODS:Brain MRI scans were obtained in people with epilepsy who participated in a rural community-based program in China between July 2010 and Decembe...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000010171

    authors: Davagnanam I,Chen Z,Hoskote C,Ding D,Yang B,Wang Y,Wang T,Li W,Duncan JS,Wang W,Sander JW,Kwan P

    更新日期:2020-09-01 00:00:00

  • Pharmacologic treatment of essential tremor.

    abstract::Essential tremor (ET) is a common movement disorder that often causes functional disability, potentially leading to physical and emotional difficulties. The paucity of data available regarding the underlying pathophysiologic mechanism of ET hinders the development of innovative approaches to pharmacotherapeutic treatm...

    journal_title:Neurology

    pub_type: 杂志文章,评审

    doi:

    authors: Koller WC,Hristova A,Brin M

    更新日期:2000-01-01 00:00:00

  • The clinical spectrum of cerebral amyloid angiopathy: presentations without lobar hemorrhage.

    abstract::Cerebral amyloid angiopathy is a common cause of spontaneous lobar hemorrhage in elderly patients. We discuss seven patients with amyloid angiopathy presenting without major lobar hemorrhage. The patients' presentations fell into two groups: recurrent transient neurologic symptoms and rapidly progressive dementia. The...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.10.2073

    authors: Greenberg SM,Vonsattel JP,Stakes JW,Gruber M,Finklestein SP

    更新日期:1993-10-01 00:00:00

  • Intellectual enrichment lessens the effect of brain atrophy on learning and memory in multiple sclerosis.

    abstract:OBJECTIVE:Learning and memory impairments are prevalent among persons with multiple sclerosis (MS); however, such deficits are only weakly associated with MS disease severity (brain atrophy). The cognitive reserve hypothesis states that greater lifetime intellectual enrichment lessens the negative impact of brain disea...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0b013e3181e396be

    authors: Sumowski JF,Wylie GR,Chiaravalloti N,DeLuca J

    更新日期:2010-06-15 00:00:00

  • A controlled trial with vasopressin analogue (DGAVP) on cognitive recovery immediately after head trauma.

    abstract::Recent evidence suggests that the vasopressin analogue desglycinamide-arginine8-vasopressin (DGAVP) might specifically benefit mild brain trauma patients. We investigated the effect of intranasal DGAVP treatment in 32 patients who had sustained a mild head injury for 3 months in a double-blind, placebo-controlled, mat...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1212/wnl.43.1_part_1.103

    authors: Bohnen NI,Twijnstra A,Jolles J

    更新日期:1993-01-01 00:00:00

  • Spinal muscular atrophy is not the result of mutations at the beta-hexosaminidase or GM2-activator locus.

    abstract::The disease locus for the clinically heterogeneous childhood spinal muscular atrophies (SMA) maps to the chromosome 5 subregion, 5q11.2-13.3. The beta-subunit of beta-D-N-acetylhexosaminidase (hexosaminidase) (EC 3.2.1.52) (Hex B) maps to the same region, and the protein required for substrate recognition by this enzy...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.41.9.1418

    authors: Kleyn PW,Brzustowicz LM,Wilhelmsen KC,Freimer NB,Miller JM,Munsat TL,Gilliam TC

    更新日期:1991-09-01 00:00:00

  • A multi-institutional study of brainstem gliomas in children with neurofibromatosis type 1.

    abstract:OBJECTIVE:To define the clinical and radiologic features of brainstem gliomas (BSGs) in children with neurofibromatosis type 1 (NF1). METHODS:We performed a retrospective cross-sectional study of 133 children with NF1 and concurrent BSGs cared for at 4 NF1 referral centers. BSG was determined using radiographic criter...

    journal_title:Neurology

    pub_type: 杂志文章,多中心研究

    doi:10.1212/WNL.0000000000003881

    authors: Mahdi J,Shah AC,Sato A,Morris SM,McKinstry RC,Listernick R,Packer RJ,Fisher MJ,Gutmann DH

    更新日期:2017-04-18 00:00:00

  • Limbic encephalitis not associated with neoplasm as a cause of temporal lobe epilepsy.

    abstract:OBJECTIVE:To describe four patients with temporal lobe epilepsy with limbic encephalitis unrelated to neoplasm. METHODS:The authors performed a retrospective evaluation of patient data obtained during presurgical evaluation, with additional CSF analyses, serum analyses, and histopathologic investigations. RESULTS:The...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.55.12.1823

    authors: Bien CG,Schulze-Bonhage A,Deckert M,Urbach H,Helmstaedter C,Grunwald T,Schaller C,Elger CE

    更新日期:2000-12-26 00:00:00

  • Magnetic resonance imaging in central nervous system sarcoidosis.

    abstract::We performed brain MRIs on 21 patients with CNS sarcoidosis. Brain CTs were performed in 18 of these. Parenchymal lesions were seen in 17 of 21 with MRI, compared with 9 of 18 with CT. MRI detected a greater number of parenchymal lesions in cases where both CT and MRI were positive, and some lesions appeared more exte...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.38.3.378

    authors: Miller DH,Kendall BE,Barter S,Johnson G,MacManus DG,Logsdail SJ,Ormerod IE,McDonald WI

    更新日期:1988-03-01 00:00:00

  • TNF-alpha expression in painful and nonpainful neuropathies.

    abstract:OBJECTIVE:To determine whether the cytokine tumor necrosis factor alpha (TNF-alpha) acts as a pain mediator in neuropathic pain in humans. BACKGROUND:In animal models, inflammatory cytokines such as TNF-alpha have been shown to facilitate neuropathic pain. METHODS:The expression of TNF-alpha was analyzed immunohistoc...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.56.10.1371

    authors: Empl M,Renaud S,Erne B,Fuhr P,Straube A,Schaeren-Wiemers N,Steck AJ

    更新日期:2001-05-22 00:00:00

  • Combined defects of muscle phosphofructokinase and AMP deaminase in a child with myoglobinuria.

    abstract::A 14-year-old boy with exercise-related myalgia and cramps had several episodes of myoglobinuria since early childhood. An episode at 2 years of age caused acute renal failure. Histochemical and biochemical analysis of muscle showed a combined defect of phosphofructokinase (PFK) and adenosine monophosphate (AMP) deami...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.50.1.296

    authors: Bruno C,Minetti C,Shanske S,Morreale G,Bado M,Cordone G,DiMauro S

    更新日期:1998-01-01 00:00:00

  • Neurotransmitters in basal ganglia and cortex of Alzheimer's disease with and without Lewy bodies.

    abstract::We measured the concentrations of the monoamines, their precursors, and their metabolites, and the activity of choline acetyltransferase (ChAT) in basal ganglia and cortical regions of postmortem brains from cases with histologically verified pure Alzheimer's disease (AD), AD with diffusely distributed Lewy bodies (Le...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.43.10.1927

    authors: Langlais PJ,Thal L,Hansen L,Galasko D,Alford M,Masliah E

    更新日期:1993-10-01 00:00:00

  • Cerebral vasculitis and hemorrhage associated with phenylpropanolamine.

    abstract::A 20-year-old woman using an oral diet aid preparation containing phenylpropanolamine presented with an intracerebral hemorrhage and angiographic evidence of cerebral vasculitis. Gas chromatography demonstrated phenylpropanolamine in the urine. Even when used within recommended guidelines, phenylpropanolamine usage sh...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.35.3.405

    authors: Fallis RJ,Fisher M

    更新日期:1985-03-01 00:00:00

  • Regional metabolic correlates of Token test results in cortical and subcortical left hemispheric infarction.

    abstract::We investigated 26 right-handed patients who had aphasia caused by a single infarct in the territory of the left middle cerebral artery (MCA) with cranial CT, positron emission tomography, and a standard language test battery including the Token test. The patients represented an unselected sample of various infarct lo...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.39.8.1083

    authors: Karbe H,Herholz K,Szelies B,Pawlik G,Wienhard K,Heiss WD

    更新日期:1989-08-01 00:00:00

  • Calcification of the basal ganglia as a cause of levodopa-resistant parkinsonism.

    abstract::We present a patient with levodopa-resistant parkinsonism due to basal ganglia calcification related to surgically-induced hypoparathyroidism. The calcification was seen on computerized axial tomography but not on skull x-rays. Such calcification should be looked for in all cases of levodopa-resistant parkinsonism, si...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.26.3.221

    authors: Klawans HL,Lupton M,Simon L

    更新日期:1976-03-01 00:00:00

  • Statin use and outcome after intracerebral hemorrhage: case-control study and meta-analysis.

    abstract:OBJECTIVES:Intracerebral hemorrhage (ICH) is a highly lethal disease of the elderly. Use of statins is increasingly widespread among the elderly, and therefore common in patients who develop ICH. Accumulating data suggests that statins have neuroprotective effects, but their association with ICH outcome has been incons...

    journal_title:Neurology

    pub_type: 杂志文章,meta分析

    doi:10.1212/WNL.0b013e3182194be9

    authors: Biffi A,Devan WJ,Anderson CD,Ayres AM,Schwab K,Cortellini L,Viswanathan A,Rost NS,Smith EE,Goldstein JN,Greenberg SM,Rosand J

    更新日期:2011-05-03 00:00:00

  • Psychogenic seizures: ictal characteristics and diagnostic pitfalls.

    abstract::We analyzed ictal features of psychogenic seizures using video-EEG recordings in 47 patients and reviewed the medical records to determine if patients received antiepileptic drug therapy and whether they were treated pharmacologically for status epilepticus. Unresponsive behavior in the absence of motor manifestations...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.42.1.95

    authors: Leis AA,Ross MA,Summers AK

    更新日期:1992-01-01 00:00:00

  • Homolateral ataxia and crural paresis: case report.

    abstract::Homolateral ataxia and crural paresis is a recognized vascular syndrome. However, confirmation of the causative lesion rests principally on one earlier case with multiple other infarcts. We studied a patient with the clinical syndrome; computerized tomography revealed a lucency that appeared within 1 week of the infar...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.30.9.1013

    authors: Perman GP,Racy A

    更新日期:1980-09-01 00:00:00

  • Diagnostic value of myotactic reflexes in axonal and demyelinating polyneuropathy.

    abstract::In 11 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and 11 patients with chronic idiopathic axonal polyneuropathy (CIAP), absent myotatic reflexes were significantly associated more often with CIDP than with CIAP, an absent biceps-reflex having the highest sensitivity and specificity for the d...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/wnl.53.7.1573

    authors: van Dijk GW,Wokke JH,Notermans NC,van Gijn J,Franssen H

    更新日期:1999-10-22 00:00:00

  • Hippocampal atrophy rates in Alzheimer disease: added value over whole brain volume measures.

    abstract:OBJECTIVE:To investigate the added value of hippocampal atrophy rates over whole brain volume measurements on MRI in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and controls. METHODS:We included 64 patients with AD (67 +/- 9 years; F/M 38/26), 44 patients with MCI (71 +/- 6 yea...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000344568.09360.31

    authors: Henneman WJ,Sluimer JD,Barnes J,van der Flier WM,Sluimer IC,Fox NC,Scheltens P,Vrenken H,Barkhof F

    更新日期:2009-03-17 00:00:00

  • Efficacy of subcutaneous sumatriptan in repeated episodes of migraine.

    abstract::This double-blind, placebo-controlled, multicenter, crossover study investigated the efficacy and tolerability of sumatriptan administered for up to three separate migraine attacks. One hundred twenty adults received sumatriptan (SC, 6 mg; three attacks) and placebo (one attack). Patients completed questionnaires asse...

    journal_title:Neurology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1212/wnl.43.7.1363

    authors: Cady RK,Dexter J,Sargent JD,Markley H,Osterhaus JT,Webster CJ

    更新日期:1993-07-01 00:00:00

  • Severe neurologic complications after hematopoietic stem cell transplantation in children.

    abstract:OBJECTIVE:To describe and evaluate the incidence and risk factors of severe neurologic events (SNE) in pediatric recipients of allogeneic or autologous hematopoietic stem cell transplantation (HSCT) for hematologic or nonhematologic diseases. METHODS:Retrospective analysis of 272 consecutive children admitted to the G...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/01.wnl.0000036608.42104.b9

    authors: Faraci M,Lanino E,Dini G,Fondelli MP,Morreale G,Dallorso S,Manzitti C,Calevo MG,Gaggero R,Castagnola E,Haupt R

    更新日期:2002-12-24 00:00:00

  • Characteristic features and progression of abnormalities on MRI for CARASIL.

    abstract:OBJECTIVES:The objective of this study was to clarify the characteristic brain MRI findings for genetically diagnosed CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy). METHODS:Seven patients with CARASIL carrying HTRA1 mutations (representing 6 Japanese families) we...

    journal_title:Neurology

    pub_type: 杂志文章

    doi:10.1212/WNL.0000000000001803

    authors: Nozaki H,Sekine Y,Fukutake T,Nishimoto Y,Shimoe Y,Shirata A,Yanagawa S,Hirayama M,Tamura M,Nishizawa M,Onodera O

    更新日期:2015-08-04 00:00:00