| Objective To explore the value of convalescent somatosensory evoked potentials (SEPs) in formulating a prognosis for children with severe disorders of consciousness (DOC) caused by brain trauma, infection or hypoxia. Methods This was a retrospective cohort study of 286 children with DOC children treated between 2013 and 2021. They were divided into a trauma group (n=103), an intracranial infection group (n=101), a hypoxia group (n=42) and an other-causes group (n=40). Their consciousness status and functional recovery were obtained in follow-up appointments, and their functional condition 1 year after discharge was assessed using the modified Glasgow Outcome scale (GOS). Results During 8-year follow-up, 16 had died, with 4 deaths within 1 year. Among the 191 cases followed up to 1 year, children with a bilateral N20 SEP had significantly better functional outcomes than those with unilateral or bilateral N20 absence. For the trauma group, the presence of a bilateral N20 signal was a strong indicator of good functional outcome at the 1-year follow-up, with a specificity of 90.9%, sensitivity of 55.6%, positive predictive value (PPV) of 92.6%, negative predictive value (NPV) of 50% and a positive likelihood rate (PLR) of 6.111. However, for the intracranial infection group, the presence of N20 had a low specificity for predicting good outcomes, though the absence of an N20 potential predicted poor functional outcome at 1 year with a specificity of 82.4%, sensitivity of 62.1%, PPV of 75%, and PLR of 3.517. For the hypoxic group, bilateral N20 could not predict a good prognosis, though its absence meant a poor outcome, with a specificity of 87.5%, sensitivity of 63.6%, PPV of 93.3%, and PLR of 5.818. Conclusion SEPs during the recovery period can help to formulate a prognosis for children with severe DOC. Traumatic brain injury and the presence of bilateral N20 potentials can be used as a good prognostic indicator. For intracranial infection and hypoxic-ischemic brain injury, the absence of an N20 potential indicates a poor prognosis. |
