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Critical Care
Published in: Critical Care 1/2020

01-12-2020 | Somatosensory Evoked Potential | Review

Brainstem dysfunction in critically ill patients

Authors: Sarah Benghanem, Aurélien Mazeraud, Eric Azabou, Vibol Chhor, Cassia Righy Shinotsuka, Jan Claassen, Benjamin Rohaut, Tarek Sharshar

Published in: Critical Care | Issue 1/2020

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Abstract

The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, impairment of consciousness, dysautonomia, and respiratory failure. The brainstem is prone to various primary and secondary insults, resulting in acute or chronic dysfunction. Of particular importance for characterizing brainstem dysfunction and identifying the underlying etiology are a detailed clinical examination, MRI, neurophysiologic tests such as brainstem auditory evoked potentials, and an analysis of the cerebrospinal fluid. Detection of brainstem dysfunction is challenging but of utmost importance in comatose and deeply sedated patients both to guide therapy and to support outcome prediction. In the present review, we summarize the neuroanatomy, clinical syndromes, and diagnostic techniques of critical illness-associated brainstem dysfunction for the critical care setting.
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Metadata
Title
Brainstem dysfunction in critically ill patients
Authors
Sarah Benghanem
Aurélien Mazeraud
Eric Azabou
Vibol Chhor
Cassia Righy Shinotsuka
Jan Claassen
Benjamin Rohaut
Tarek Sharshar
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2020
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-019-2718-9

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