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"Neonates"

Original Articles
Predictive Value of Multi-Sensory Evoked Potentials on Motor Development of Neonates.
Kim, Sei Joo , Lee, Eun Ha , Song, Eun Beom , Lee, Sang Heon , Cho, Young Jin , Lee, Myung Heun
J Korean Acad Rehabil Med 1999;23(3):544-558.

Objective: This study was performed to investigate the prognostic value of multi-sensory evoked potentials (MSEPs) in neonatal period for the early diagnosis of delayed motor development, especially cerebral palsy.

Method: The MSEPs studies composed of auditory brainstem evoked potentials (AEPs), visual evoked potentials (VEPs) and somatosensory evoked potentials were taken on 237 neonates, 136 boys and 101 girls, using Viking IV machine. Follow up MSEPs were repeated in every 4 or more weeks for those who showed abnormal responses in any of the MSEPs. Each neonate was also evaluated for motor development as an outpatient or by telephone interview.

Results: Among 237 neonates, 6.4% showed delayed development, and 4.6% were cerebral palsy: 3.8%, spastic type; 0.8%, athetoid type, and the others revealed normal motor development. AEP was useful method to predict motor development when this was done at 39.7⁑0.4 weeks of postmenstrual age (PMA). VEPs failed to show the validity, but there was the typical waveform change in accordance with increase of the postmenstrual age. Median nerve SEPs were valuable for prediction of motor development which were taken at PMA 40.7⁑0.6 weeks. After 45.3⁑1.5 weeks of PMA, median nerve SEPs did not reflect motor development outcome significantly. However, posterior tibial SEPs significantly reflect motor outcome regardless of the time of examination.

Conclusion: Median and posterior tibial SEPs done before 40weeks of PMA are useful tool to predict motor development outcome. When any of these tests showed abnormal findings, follow up study is recommended and posterior tibial SEP study is thought to be the most useful for its predictability. It is necessary to correlate the AEPs and VEPs with hearing and vision whenever abnormal findings are found.

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Somatosensory Evoked Potentials in Neonates.
Lee, Eun Ha , Lee, Myung Heun , Na, Jin Kyung , Park, Yoon Hyung , Yoon, Joon Shik , Kim, Dong Hwee , Lee, Sang Heon , Kim, Sei Joo
J Korean Acad Rehabil Med 1998;22(1):153-161.

The purpose of this study was to investigate the maturation characteristics of neonates.

Ninety three neonates underwent a somatosensory evoked potentials(SEPs) testing. Twenty four point seven percent of them were neonates at risks including the neonatal asphyxia, low birth weight under 1500 g, or a suspicious CNS abnormality.

Seventy five point three percent of neonates showed normal median SEPs, and 24.7% of them showed abnormal or a flat response. The mean latency of the first cortical component(N1) was 25.3⁑5.4 msec, duration 16.3⁑5.5 msec and amplitude 1.00⁑1.27 ㄍV.

Thirty one point two percent of neonates showed normal posterior tibial SEPs, and 68.8% showed abnormal or a flat response. The mean latency of the first cortical component(P1) was 44.9⁑5.6 msec, duration 17.5⁑3.9 msec and amplitude 0.47⁑0.38 ㄍV.

This result suggests that the maturation of rostal nervous system develops earlier than the caudal system.

Linear decrease of the cortical latency with post-menstrual age reflects maturation of the central pathway and not merely maturation of the peripheral nerves. But our study showed much less frequency of recordings of the tibial nerve SEPs than the median nerve responses, which suggested that the maturation of spinal cord and lower-limb nerves would be slow, in addition to that the length of pathway was increasing. This result suggests that the maturation of the proximal shorter nervous pathway develops earlier than the distal longer pathway.

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