Standards of clinical practice of EEG and EPs in comatose and other unresponsive states. The International Federation of Clinical Neurophysiology.

Electrophysiological methods such as electroencephalography and evoked potential studies (EEG and EPs) provide functional assessment of the central nervous system (CNS). As such, their scope parallels that of the clinical examination and is complementary to that of imaging techniques (CT scan, MRI), which provide structural assessment. Indeed, CNS dysfunction may occur with or without evidence of structural lesions of the corresponding structures and CNS lesions may provoke functional disturbances that are outside the domain of the electrophysiological examination. Functional assessment can be used as an adjunct to diagnose the origin of unresponsive states, as a means to predict outcome, and for monitoring purposes (Chatrian et al. 1996). The interpretation of the neurophysiological results depends on the etiology of the coma and should take into account both nonpathological factors (body temperature, drugs) and primarily non-cerebral pathological factors (peripheral sensory pathologies, metabolic disturbances) that are apt to interfere with brain function.

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