Use of evoked potentials in the ICU

Abstract

In the ICU, serial analysis of cortical evoked potentials will give an idea of the possible status in patients with head trauma. A representative example shows a patient with severe head trauma who had been involved in a car accident. The SEP shows a marked difference in regard to right and left median nerve stimulation (Fig. 93a). Although CT scan revealed no signs of intracerebral mass bleeding, there was a left arm paralysis, a left sided mydriasis, with a radiologically verified fracture at the base of the scull. The pathologically reduced amplitude of the early potentials during left median nerve stimulation suggested a left-sided functional deficit involving the medulla. In the following days of intensive care therapy, sings of recovery became evident as the amplitude increased in height being similar to right median nerve stimulation (Fig. 93b-c).