The utility of SSEPs in the ICU

By Alex Yartsev - Jul 11, 2015
Last updated Fri, 03/02/2018 - 19:59
 Topic: Neurology and Neurosurgery

The college wanted their candidates to "critically evaluate the role" of SSEPs in  Question 2 from the first paper of 2005. Another question on SSEP results was Question 11 from the second paper of 2014 ("Describe how SSEPs can be used for prognostication in patients with hypoxic-ischaemic brain injury"); by a totally arbitrary decision that question was left in the Cardiac Arrest and Resuscitation revision section.

Advantages and Disadvantages of SSEPs in ICU

Advantages

Disadvantages

  • This is a low-yield investigation
  • It requires specialist interpretation
  • Following cardiac arrest, SSEPs have a better capacity to identify patients with poor outcome than to predict good outcome. 
  • Intermediate test results are common, and difficult to interpret.
  • Coexisting spinal lesions may affect cortical response
  • Confounded by noise from muscle activity (easier to perform in paralysed patients)

References

Guérit, J-M., et al. "Consensus on the use of neurophysiological tests in the intensive care unit (ICU): electroencephalogram (EEG), evoked potentials (EP), and electroneuromyography (ENMG)." Neurophysiologie Clinique/Clinical Neurophysiology 39.2 (2009): 71-83.

Tjepkema-Cloostermans, Marleen Catharina, J. Horn, and M. J. A. M. Putten. "The SSEP on the ICU: Current applications and pitfalls." Netherlands journal of critical care 17.1 (2013): 5-9.

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