A multimodal neurophysiologic approach to predicting pediatric traumatic brain injury outcome

Traumatic brain injury (TBI) is the leading cause of death and acquired disability in the pediatric population. No accurate method of predicting TBI outcome exists. Electroencephalogram (EEG) and evoked potentials (EPs) are possible predictors. The study's hypotheses are that combining EEG and EPs scores will predict TBI outcome and that EEG synchrony will provide new information on brain function. Fourteen children with head injury, admitted to the critical care unit were recruited along with ten age and gender matched controls. Patients had two sets of visual and somatosensory evoked potentials (SEP) and EEG performed three days apart. The Pediatric Cerebral Performance Category score (PCPC) measured outcome at twelve months post TBI. EEG was the strongest individual predictor of outcome. Combining EEG and SEP scores improved their sensitivity. EEG synchrony correlated with TBI lesions found on CT scans. EEG temporal variability increased as patients recovered and emerged from coma (p< 0.001).