Bilateral loss of cortical somatosensory evoked potential at birth predicts cerebral palsy in term and near-term newborns

Suppiej, A.; Cappellari, A.; Franzoi, M.; Traverso, A.; Ermani, M.; Zanardo, V.

doi:10.1016/j.earlhumdev.2010.01.024

« Previous Next »Early Human Development
Volume 86, Issue 2 , Pages 93-98, February 2010

Bilateral loss of cortical somatosensory evoked potential at birth predicts cerebral palsy in term and near-term newborns

A. Suppiej
- Child Neurology and Clinical Neurophysiology Unit, Department of Paediatrics, University of Padova, Italy
- Corresponding author. Via Giustiniani n. 3, 35128 Padova, Italy. Tel.: +39 049 8213505; fax: +39 049 8213509.
A. Cappellari
- Child Neurology and Clinical Neurophysiology Unit, Department of Paediatrics, University of Padova, Italy
M. Franzoi
- Child Neurology and Clinical Neurophysiology Unit, Department of Paediatrics, University of Padova, Italy
A. Traverso
- Child Neurology and Clinical Neurophysiology Unit, Department of Paediatrics, University of Padova, Italy
M. Ermani
- Bio statistical Unit, Department of Neurosciences, University of Padova, Italy
V. Zanardo
- Neonatal Intensive Care Unit, Department of Paediatrics, University of Padova, Italy

Received 16 July 2009; received in revised form 21 January 2010; accepted 29 January 2010.

Abstract

Bilateral loss of cortical somatosensory evoked potential (SEP) is considered the single best indicator of adverse outcome in acute encephalopathy of adult patients and older children. This study determines whether the presence or absence of the neonatal cortical SEP can predict cerebral palsy at two years in survivors of neonatal encephalopathy scored according to Sarnat criteria. We also compare SEPs with visual evoked potentials (VEPs), the EEG and neonatal neurological status.

Fifty-nine neonates admitted to the neonatal intensive care unit had SEP, VEP and EEG recordings analysed according to the presence (n=37, 63%) or absence (n=22, 37%) of neonatal encephalopathy (score ≥1).

Cortical SEP was always present in the perinatal period in those surviving without major neurological disability, while it was bilaterally absent in all but one patient with a subsequent diagnosis of cerebral palsy. Multivariate analysis using the logistic regression model showed that bilateral loss of cortical SEP and Sarnat Score correctly classified the neurological outcome in all patients.

Bilateral absence of cortical SEP indicates early identification of neonates at risk of cerebral palsy indicating that EPs have a clinical role in the workup of neonatal encephalopathy.

Keywords: Encephalopathy, Cerebral palsy, SEP, Neonate, Near-term, Term