Chapter 15. Early Neurophysiological Assessment After Insult to the Central Nervous System

  1. Ruth Porter and
  2. David W. Fitzsimons
  1. G. Pampiglione

Published Online: 30 MAY 2008

DOI: 10.1002/9780470720165.ch15

Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System

Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System

How to Cite

Pampiglione, G. (1975) Early Neurophysiological Assessment After Insult to the Central Nervous System, in Ciba Foundation Symposium 34 - Outcome of Severe Damage to the Central Nervous System (eds R. Porter and D. W. Fitzsimons), John Wiley & Sons, Ltd., Chichester, UK. doi: 10.1002/9780470720165.ch15

Author Information

  1. Department of Clinical Neurophysiology, The Hospital for Sick Children, London

Publication History

  1. Published Online: 30 MAY 2008
  2. Published Print: 1 JAN 1975

ISBN Information

Print ISBN: 9789021940380

Online ISBN: 9780470720165

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Keywords:

  • brain function;
  • neurophysiological assessment;
  • central nervous system;
  • polyelectromyography;
  • cardiorespiratory arrest

Summary

Cerebral insult is a generic term which includes many causes of altered cerebral function. Neurophysiological investigations, closely integrated with clinical and metabolic studies, should begin at an early stage after any such insult (namely in the first few hours) to provide information on the type, severity and evolution of altered brain function. The present contribution is based on prospective studies on 200 children with closed head injuries and 500 children who had been resuscitated following cardiocirculatory or respiratory arrest. In addition to electroencephalography, other neurophysiological investigations may be carried out whenever necessary including electroretinography, evoked potential studies and polyelectromyography at the patient's bedside, whether or not in the intensive care situation.

The rapid evolution of metabolic events and of both clinical and neurophysiological features characterizes the acute initial phase, in marked contrast to the more static features of long term sequelae to a cerebral insult. Experience over the past 25 yr has shown that no rule is applicable to every case because of the diversity of individual circumstances. However, a well planned early neurophysiological assessment after insult to the central nervous system has given reliable prognostic criteria for the subsequent management of each patient and for the evaluation of any complications during the first few weeks of treatment.