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Title: The assessment of asphyxiated term infants by somatosensory evoked potentials
Author: Gibson, Neil Alexander
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1995
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Forty healthy term infants had SEP measured from surface electrodes over the cervical cord and cortex after median nerve stimulation at the wrist. A wide normal range of response was encountered. The cervical response was fairly stable and consisted of up to three negative peaks with the largest amplitude peak at a mean of 10.2 mscec after the stimulus. The configuration was similar to that found in older children and adults. The cortical trace was found to vary markedly and consisted of a wave which was of increasing complexity with increasing postmenstrual age (PMA). The mean for the peak of the first negative wave (N1) being 30.0 msec. There was a negative correlation between increasing PMA and latency of N1. Subsequent study was made of 30 term infants over the course of their asphyxial encephalopathy. The cervical response was normal in all but one infant but three types of cortical SEP were measured in these infants: a normal response; a immature/delayed response or an absent response. In general, over time, the SEP went from abnormality towards normality. The more asphyxiated infants had the more abnormal SEP results. Ten of the infants died. The surviving infants were seen at a mean age of 12 months for a neurological examination and Griffiths developmental assessment. Thirteen were unequivocally normal, 4 had doubtful findings at follow-up and 3 had cerebral palsy. There was a good correlation between SEP results and outcome. All infants with normal SEP by 4 days of age were unequivocally normal at one year. All the others had abnormal SEP beyond four days. The results suggest that SEP is a useful objective test in the evaluation of term infants who have suffered perinatal asphyxia and has additive weight to encephalopathy grade in prognostic assessment.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available