Table 1 Summary of clinical characteristics (when known) and details of recovery in survivors of cardiac arrest reported to lack N20 responses on somatosensory evoked potentials. In each case, the false positive result is disputed
References | Outcome (timing after ROSC) | Temperature management | Onset known | SSEP | Clinical data | Authors’ conclusions or limitations |
|---|---|---|---|---|---|---|
Arch et al. [52] | Ambulate with walker, dysarthric speech at 22 days | TH to 32–34 °C | Unknown | Absent N20 at 49 h | 31-year-old CA “victim” Sluggish pupils No response to pain | Inadequate clinical data AH possible at the outset No core body temp |
Bender et al. [53] | CPC 2 at 6 months | No TH | +CA while playing soccer | Non-standard montages at days 3 and 9 | 16 years old No data | No clinical data SSEP not reliable |
Bouwes et al. [32] | 3 cases | TH to 32–34 °C | No data | “Technical difficulties” | No data | FPR “refuted” by authors |
Codeluppi et al. [54] | Normal neurologic examination | TH at 33 °C × 24 h | +Multi-drug overdose | Uninterpretable: “noise” at 84 h | 34-year-old M with GCS 4 | AH possible No core body temp SSEP: “noise” |
Dragancea et al. [55] | CPC 2 at ICU discharge, CPC 1 at 6 months | TH at 36 °C | No data | “Technical artifacts” at 77 h | No data | SSEP “interpretation difficult” No clinical data |
Guerit et al. [56] | 2 cases: GOS 4–5 | No TH | +Anesthesia accidents | Misinterpreted as absent N20 | One 25-year-old M made full recovery | SSEP in only figure shows attenuated, not absent N20 |
Howell et al. [19] | GOS 4–5 at 8 months | No TH | No data | Bilaterally absent N20 No SSEP figure to review | 25-year-old M comatose for 1 week Recovery of Cs after 10 weeks | No clinical data AH possible No core body temp No SSEP to review |
Karunasekara et al. [58] | CPC 2 | No TH | +Attempted hanging | Figure 2 Uninterpretable: “noise” | 51-year-old M GCS 3 Pupils sluggish At 6 days, response to pain | “Neck injury reduces validity of N20 SSEP use in prognostication” SSEP: “noise” |
Leithner et al. [48] | Regained Cs with normal cognition at 18 months | TH at 36 °C | Alcoholic “found down” | Absent N20 at 3 days Normal SSEP at 18 months No SSEP montages | No clinical data | No head MRI/CT to evaluate for trauma No clinical data |
Weinstein et al. [59] | Dysarthria Ambulates with cane at 6 months | TH at 33 °C × 24 h | No data | Absent N20 at 20 days Montages not recorded | 36-year-old F No clinical data Opens eyes day 29 Follows commands day 31 | No clinical data No SSEP montages for review |
Young et al. [60] | GOS between 3 and 5 at 3 months | No TH | No data | No figure to review | Eventually recovered awareness | Author attributes to “Watershed ischemia” |