The role of cortical evoked responses in predicting neuromotor outcome in very preterm infants.

To explore the role of posterior tibial somatosensory evoked potentials (SSEP) and flash visual evoked potentials (VEP) in the early prediction of functional brain injury, 93 infants of less than 32 weeks gestation at birth were studied. Neuromotor outcome was defined by clinical examination at the age of 2 years. SSEP, VEP and cerebral ultrasound were compared as predictors of neuromotor outcome. Posterior tibial SSEP were the most accurate single method of predicting neuromotor abnormalities with a 83% positive predictive power for cerebral palsy and a 100% predictive power for abnormal neurology, compared to 17% and 40% for cerebral ultrasound and 38% and 85% for VEP respectively. When SSEP and VEP results were concordant, the positive predictive power for cerebral palsy and abnormal neurology was 100%. Our results suggest that posterior tibial SSEP and VEP are accurate tools in the prediction of outcome in very preterm infants.