Prediction of outcome of prolonged coma caused by brain damage.
Prediction of outcome of prolonged coma caused by brain damage.
复制标题
预测脑损伤引起的长期昏迷的结果。
作者：
T. Tsubokawa;Takamitsu Yamamoto;Y. Katayama
对31例持续昏迷2个月以上的长时间昏迷患者，采用脑电图、连续脑电图频率分析压缩谱阵列、BSR、SEP、SSEP进行电生理分类。将这些患者的长期随访（至少8个月）的预后与电生理分析结果和长时间昏迷患者的神经学分级进行比较。在连续脑电图频率分析中，22例为变化谱图，9例为缓慢单调谱图，无一例为边缘谱图。我们还将变化谱图分为以下三种模式：不去同步、轻微去同步和去同步。9例慢单调谱图显示脑干及脑功能严重损伤，多模态诱发电位显示，多数患者无呼吸辅助不能生存。22例变化谱患者均为轻度脑干及脑功能损伤，多模态诱发电位，与持续性植物人状态一致。其中3例患者在电生理评估后6个月内从持续植物人状态自发恢复，表现为不同步模式，BSR正常，SEP和SSEP N20正常。我们认为，评估长时间昏迷的脑功能和预后不仅需要神经学分类，还需要电生理分类。
Thirty-one prolonged coma patients, who continued in a comatose state for at least 2 months, were classified electrophysiologically employing EEG, a compressed spectral array of continuous EEG frequency analysis, BSR, SEP and SSEP. The prognoses of long-term follow-up (at least 8 months) in these patients were compared with the results of such electrophysiological analysis and with the neurological gradings of the prolonged coma patients. In the continuous EEG frequency analysis, 22 cases were classified as having a changeable spectrogram, nine cases as having a slow monotonous spectrogram, and no cases as having a borderline spectrogram. We also classified the changeable spectrograms into the following three patterns: no desynchronization, slight desynchronization, and desynchronization. The nine cases with a slow monotonous spectrogram revealed severe damage of the brain stem and cerebral function with multimodality evoked potentials, and most of these cases could not survive without assisted respiration. The 22 cases with a changeable spectrogram had mild damage of the brain stem and cerebral function with multimodality evoked potentials, and these cases were identical with a persistent vegetative state. Three of the cases showed a changeable spectrogram that revealed a desynchronization pattern, normal BSR and normal N20 of SEP and SSEP, recovered spontaneously from the persistent vegetative state within 6 months after electrophysiological evaluation. We conclude that not only a neurological but also an electrophysiological classification is necessary to evaluate the brain function and prognosis of prolonged coma.
DOI：
10.1016/0013-4694(82)90020-7
发表时间：
1982
期刊：
Electroencephalography and clinical neurophysiology
影响因子：
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作者：
Dong,WK;Harkins,SW;Ashleman,BT
通讯作者：
Ashleman,BT